Management of post-traumatic stress disorder: A protocol for a multiple treatment comparison meta-analysis of randomized controlled trials.


Journal

Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R

Informations de publication

Date de publication:
Sep 2019
Historique:
entrez: 3 10 2019
pubmed: 3 10 2019
medline: 9 10 2019
Statut: ppublish

Résumé

Most systematic reviews have explored the efficacy of treatments on symptoms associated with post-traumatic stress disorder (PTSD), which is a chronic and often disabling condition. Previous network meta-analysis (NMA) had limitations such as focusing on pharmacological or psychotherapies. Our review is aims to explore the relative effectiveness of both pharmacological and psychotherapies and we will establish the differential efficacy of interventions for PTSD in consideration of both symptom reduction and functional recovery. We will conduct a network meta-analysis of randomized controlled trials evaluating treatment interventions for PTSD. We will systematically search Medline, PILOT, Embase, CINHAL, AMED, Psychinfo, Health Star, DARE and CENTRAL to identify trials that: (1) enroll adult patients with PTSD, and (2) randomize them to alternative interventions or an intervention and a placebo/sham arm. Independent reviewers will screen trials for eligibility, assess risk of bias using a modified Cochrane instrument, and extract data. Our outcomes of interest include PTSD symptom reduction, quality of life, functional recovery, social and occupational impairment, return to work and all-cause drop outs. We will conduct frequentist random-effects network meta-analysis to assess relative effects of competing interventions. We will use a priori hypotheses to explore heterogeneity between studies, and assess the certainty of evidence using the GRADE approach. This network meta-analysis will determine the comparative effectiveness of therapeutic options for PTSD on both symptom reduction and functional recovery. Our results will be helpful to clinicians and patients with PTSD, by providing a high-quality evidence synthesis to guide shared-care decision making.

Sections du résumé

BACKGROUND BACKGROUND
Most systematic reviews have explored the efficacy of treatments on symptoms associated with post-traumatic stress disorder (PTSD), which is a chronic and often disabling condition. Previous network meta-analysis (NMA) had limitations such as focusing on pharmacological or psychotherapies. Our review is aims to explore the relative effectiveness of both pharmacological and psychotherapies and we will establish the differential efficacy of interventions for PTSD in consideration of both symptom reduction and functional recovery.
METHODS METHODS
We will conduct a network meta-analysis of randomized controlled trials evaluating treatment interventions for PTSD. We will systematically search Medline, PILOT, Embase, CINHAL, AMED, Psychinfo, Health Star, DARE and CENTRAL to identify trials that: (1) enroll adult patients with PTSD, and (2) randomize them to alternative interventions or an intervention and a placebo/sham arm. Independent reviewers will screen trials for eligibility, assess risk of bias using a modified Cochrane instrument, and extract data. Our outcomes of interest include PTSD symptom reduction, quality of life, functional recovery, social and occupational impairment, return to work and all-cause drop outs.
RESULTS RESULTS
We will conduct frequentist random-effects network meta-analysis to assess relative effects of competing interventions. We will use a priori hypotheses to explore heterogeneity between studies, and assess the certainty of evidence using the GRADE approach.
CONCLUSION CONCLUSIONS
This network meta-analysis will determine the comparative effectiveness of therapeutic options for PTSD on both symptom reduction and functional recovery. Our results will be helpful to clinicians and patients with PTSD, by providing a high-quality evidence synthesis to guide shared-care decision making.

Identifiants

pubmed: 31574805
doi: 10.1097/MD.0000000000017064
pii: 00005792-201909270-00014
pmc: PMC6775348
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e17064

Références

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Auteurs

Yasir Rehman (Y)

Department of Health Research Methods, Evidence, and Impact (HEI).
The Michael G. DeGroote Institute of Pain Research and Care, McMaster University.
Canadian Academy of Osteopathy (CAO).

Behnam Sadeghirad (B)

Department of Health Research Methods, Evidence, and Impact (HEI).
The Michael G. DeGroote Institute of Pain Research and Care, McMaster University.

Gordon H Guyatt (GH)

Department of Health Research Methods, Evidence, and Impact (HEI).

Margaret C McKinnon (MC)

Department of Psychiatry and Behavioral Neurosciences, McMaster University.
Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton.
Homewood Research Institute, Guelph.

Randi E McCabe (RE)

Department of Psychiatry and Behavioral Neurosciences, McMaster University.
Anxiety Treatment & Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton.

Ruth A Lanius (RA)

Homewood Research Institute, Guelph.
Imaging Division, Lawson Health Research Institute.
Department of Psychiatry and Neurosciences Western University.

Donald J Richardson (DJ)

MacDonald/Franklin OSI Research Centre, Western University.
Lawson Health Research Institute.
Parkwood Hospital Operational Stress Injury Clinic, St. Joseph's Health Care London.
Department of Psychiatry and Neurosciences Western University, London.

Rachel Couban (R)

The Michael G. DeGroote Institute of Pain Research and Care, McMaster University.

Jason W Busse (JW)

Department of Health Research Methods, Evidence, and Impact (HEI).
The Michael G. DeGroote Institute of Pain Research and Care, McMaster University.
Department of Anesthesia.
The Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada.

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