Evidence map›Paper›PMID 23222034›Full record

Trial reportAnnals of surgery2013

A randomized stepped care intervention trial targeting posttraumatic stress disorder for surgically hospitalized injury survivors.

Douglas Zatzick, Gregory Jurkovich, Frederick P Rivara, Joan Russo, Amy Wagner, Jin Wang, Chris Dunn, Sarah Peregrine Lord, Megan Petrie, Stephen S Oʼconnor and 1 more

2 registry-linked trialsAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 117 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
117citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00270959 phase1completednot on this map

Early Combined Intervention After Traumatic Injury

TypeinterventionalSponsorUniversity of WashingtonRan2006 to 2013Enrolled207ConditionsPost-Traumatic Stress DisorderArmsCognitive Behavioral Therapy, Motivational Interviewing, FDA-Approved Anti-Anxiety Medications, Standard Care Control
NCT03109431 nacompletednot on this mapstarted 2017, after this paper: background citation

Optimizing the HIV Treatment Continuum With a Stepped Care Model for Youth Living With HIV

TypeinterventionalSponsorUniversity of California, Los AngelesRan2017 to 2022Enrolled170ConditionsHIV, Mental Health, Illicit Substance Use, Sexually Transmitted Infections (STI)ArmsLevel 1, Level 2, Level 3
3 · Its place in the literature

Who cites it

117 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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57 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Douglas ZatzickDepartment of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98104, USA. dzatzick@u.washington.edu
Gregory Jurkovich
Frederick P Rivara
Joan Russo
Amy Wagner
Jin Wang
Chris Dunn
Sarah Peregrine Lord
Megan Petrie
Stephen S Oʼconnor
Wayne Katon

Funding

Early Combined Intervention After Traumatic InjuryR01MH073613 · NIMH · UNIVERSITY OF WASHINGTON · PI ZATZICK, DOUGLAS F · 2005 to 2010
$2.7M
Research, Mentoring & Dissemination for PTSD Intervention in Acute Care SettingsK24MH086814 · NIMH · UNIVERSITY OF WASHINGTON · PI ZATZICK, DOUGLAS F · 2010 to 2014
$867k
NIMH NIH HHS K24 MH086814NIMH NIH HHS K24/MH086814NIMH NIH HHS R01 MH073613NIMH NIH HHS R01/MH073613
6 · The paper itself

Abstract

objectiveTo test the effectiveness of a stepped care intervention model targeting posttraumatic stress disorder (PTSD) symptoms after injury.

backgroundFew investigations have evaluated interventions for injured patients with PTSD and related impairments that can be feasibly implemented in trauma surgical settings.

methodsThe investigation was a pragmatic effectiveness trial in which 207 acutely injured hospitalized trauma survivors were screened for high PTSD symptom levels and then randomized to a stepped combined care management, psychopharmacology, and cognitive behavioral psychotherapy intervention (n = 104) or usual care control (n = 103) conditions. The symptoms of PTSD and functional limitations were reassessed at 1, 3, 6, 9, and 12 months after the index injury admission.

resultsRegression analyses demonstrated that over the course of the year after injury, intervention patients had significantly reduced PTSD symptoms when compared with controls [group by time effect, CAPS (Clinician-Administered PTSD Scale): F(2, 185) = 5.50, P < 0.01; PCL-C (PTSD Checklist Civilian Version): F(4, 185) = 5.45, P < 0.001]. Clinically and statistically significant PTSD treatment effects were observed at the 6-, 9-, and 12-month postinjury assessments. Over the course of the year after injury, intervention patients also demonstrated significant improvements in physical function [MOS SF-36 PCS (Medical Outcomes Study Short Form 36 Physical Component Summary) main effect: F(1, 172) = 9.87, P < 0.01].

conclusionsStepped care interventions can reduce PTSD symptoms and improve functioning over the course of the year after surgical injury hospitalization. Orchestrated investigative and policy efforts could systematically introduce and evaluate screening and intervention procedures for PTSD at US trauma centers. (

trial registrationclinicaltrials.gov identifier: NCT00270959).

Indexed as

Trauma CentersAdultCognitive Behavioral TherapyFeasibility StudiesFemaleFollow-Up StudiesHumansMaleRetrospective StudiesSeverity of Illness IndexStress Disorders, Post-TraumaticTreatment OutcomeWounds and Injuries

Identifiers

PMID23222034
PMCPMC3582367

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.