1. Evidence is suggestive but not sufficient to conclude the efficacy of X in the treatment of PTSD. (The committee may note inconsistencies in the data.)

  2. Evidence is inadequate to determine the efficacy of X in the treatment of PTSD.

  3. Evidence is suggestive that X treatment is ineffective in treating PTSD.

  4. Evidence is suggestive that X treatment is harmful in the treatment of PTSD.

  1. For each of the conclusions above, the restriction of the conclusion regarding the population, provider, setting [of] intervention, or comparator intervention will be noted.

  1. As part of its assessment, the IOM committee shall note limitations in the evidence base and make suggestions for further research that could strengthen the evidence or address research gaps in the treatment of PTSD.

  2. In conducting its work, the committee shall consider the following questions in relation to treatment modalities (including pharmacotherapy and psychotherapy) and treatment goals for individuals diagnosed with PTSD.

    1. What are the goals of PTSD treatment?

      • What is the definition of recovery?

      • For what proportion of patients is recovery possible?

      • Besides recovery, what other outcomes would benefit patients?

    1. Does evidence support the value of early intervention?

    2. How long should treatment continue?

      • What is the impact of a hiatus in treatment?

      • What is the impact of periodic reexamination for asymptomatic patients?

  1. The committee shall note when the evidence base does not allow for responding to these questions due to insufficient research attention or poorly conducted studies.

THE STUDY PROCESS

The committee held five meetings over a period of approximately nine months. The first meeting on January 16–17, 2007, part of which was an information-gathering session open to the public, included presentations from the sponsor, several subject experts, and veterans organizations (this meeting agenda can be found in Appendix F). The following four meetings were held in closed session (the fifth meeting took place via conference call). Additionally, the committee held weekly conference calls to plan the literature search, discuss findings, and formulate conclusions and recommendations.



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