Enhancing Equitable and Effective (E-3) Post Traumatic Stress Disorder (PTSD) Disability Assessment (E-3PTSD)

VA Office of Research and Development

Status: Completed

Conditions: Post-Traumatic Stress Disorder

Treatments: Behavioral: Nonstructured Interview; Behavioral: CAPS/WHODAS

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT00699660

SDR 06-331

Details and patient eligibility

About

This project evaluated the impact of semi-structured, standardized interviews on the initial PTSD C&P on the examination.

Full description

Our objective is to compare the process and outcomes of C&P exams for PTSD conducted with CAPS and WHODAS-II interviews versus the PTSD exams conducted without the CAPS and WHODAS-II interviews. This project will conduct a randomized controlled trial on 688 veterans to evaluate the effects of the CAPS/WHODAS instruments on the initial PTSD C&P examination process. Study outcomes include variation in assessing the DSM-IV components of PTSD, diagnostic accuracy, veteran perception of the exam process, VBA rater utility and resource utilization. This project will 1) demonstrate the feasibility of conducting program evaluation and intervention studies on the PTSD C&P examination process, 2) develop research tools, instruments and methods for C&P evaluation, 3) provide data on the value-added contribution of CAPS and WHODAS-II to the PTSD assessment process and examination report, and 4) inform the business case of utilizing the CAPS and WHODAS-II in the PTSD C&P process. The ultimate aim is to improve the reproducibility, consistency and validity of the PTSD examination process while maintaining a level of efficiency and cost restraint that provides veterans with an exam process that is fair, accurate and equitable across VHA.

Enrollment: 406 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Veterans referred to VHA for an Initial PTSD Compensation and Pension Examination
2. Informed consent

Exclusion criteria

1. Mentally impaired, not able to give informed consent
2. English speaking

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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406 participants in 2 patient groups

CAPS/WHODAS

Experimental group

Description:

PTSD assessed using Clinical Assessment of PTSD Symptoms (CAPS) and WHODAS functional impairment structured evidence-based interview

Treatment:

Behavioral: CAPS/WHODAS

Nonstructured Interview

Active Comparator group

Description:

Usual clinical interview to assess PTSD, without CAPS or WHODAS

Treatment:

Behavioral: Nonstructured Interview