Impact of evidence-based standardized assessment on the disability clinical interview for diagnosis of service-connected PTSD: a cluster-randomized trial

J Trauma Stress. 2012 Dec;25(6):607-15. doi: 10.1002/jts.21759.

Abstract

Posttraumatic stress disorder (PTSD) is one of the fastest growing compensated medical conditions. The present study compared usual disability examiner practices for PTSD with a standardized assessment that incorporates evidence-based assessments. The design was a multicenter, cluster randomized, parallel-group study involving 33 clinical examiners and 384 veterans at 6 Veterans Affairs medical centers. The standardized group incorporated the Clinician Administered PTSD Scale and the World Health Organization Disability Assessment Schedule-II into their assessment interview. The main outcome measures were completeness and accuracy of PTSD diagnosis and completeness of functional assessment. The standardized assessments were 85% complete for diagnosis compared to 30% for nonstandardized assessments (p < .001), and, for functional impairment, 76% versus 3% (p < .001). The findings demonstrate that the quality of PTSD disability examination would be improved by using evidence-based assessment.

Trial registration: ClinicalTrials.gov NCT00699660.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Disability Evaluation*
  • Disabled Persons
  • Evidence-Based Medicine / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / diagnosis*
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / diagnosis*
  • United States
  • Veterans
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT00699660