Schnurr 2003.
Methods | Randomised controlled trial | |
Participants | 360 male Vietnam War veterans with DSM‐IV PTSD in the USA | |
Interventions | Weekly present‐focused group CBT for 30 weeks (n = 180) vs weekly trauma‐focused CBT group therapy for 30 weeks (n = 180) | |
Outcomes | CAPS, GHQ, SF36 | |
Notes | Experienced therapists delivered therapy, and treatment adherence was assessed. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | High risk | Quote: "The randomizations were performed using permuted blocks of 4 in 3 blocks of CAPS severity scores to ensure balance in treatment groups by CAPS score." Comment: The method of random sequence generation was not reported. |
Allocation concealment (selection bias) | Unclear risk | Comment: There is no mention of any measures taken to conceal allocation. |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Quote: "Often, intention‐to‐treat analysis is performed by using an individual’s last measurement before treatment dropout as the last outcome or by carrying it forward. This method has been criticized for the bias it can introduce. Instead, we attempted to measure participants regardless of the number of treatment sessions they attended or their treatment dropout status. To our knowledge, no previous studies of PTSD treatment have taken this approach, which is standard in clinical trials in other fields of medicine. Therefore, we also performed secondary analyses to examine the effect of TFGT among participants who completed most of the scheduled sessions." Comment: 62 dropped out from the TF group and 45 from the non‐TF group. |
Selective reporting (reporting bias) | Unclear risk | Comment: All specified outcomes were reported. |
Other bias | Low risk | Comment: no other sources of bias detected. |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Comment: Participants were aware of their allocation. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Quote "Assessments were performed by a master’s‐ or doctoral level clinician who was unaware of treatment assignment." |