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

Not Applicable

Completed

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

Detailed 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.

Recruitment & Eligibility

Inclusion Criteria

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

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
CAPS/WHODAS	CAPS/WHODAS	PTSD assessed using Clinical Assessment of PTSD Symptoms (CAPS) and WHODAS functional impairment structured evidence-based interview
Nonstructured Interview	Nonstructured Interview	Usual clinical interview to assess PTSD, without CAPS or WHODAS

Primary Outcome Measures

Name	Time	Method
Completeness and Quality of PTSD Interview	Post-exam, same day	total completeness of diagnostic assessment score, range from 0 to 100% and completeness of functional assessment

Secondary Outcome Measures

Name	Time	Method
Patient Satisfaction	post-exam, same day	Mean score on satisfaction survey rating scale from 1 to 5 (higher)
Resource Utilization	same day	time spent administering the exam
PTSD Diagnosis	Post-exam, same day	Number of participants who were unable to receive a conclusive clinician PTSD diagnosis for positive or negative PTSD symptoms (unable to determine clinician diagnosis).

Locations (11): Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR
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North Little Rock, Arkansas, United States
VA Palo Alto Health Care System, Palo Alto, CA
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Palo Alto, California, United States
VA Connecticut Healthcare System West Haven Campus, West Haven, CT
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West Haven, Connecticut, United States
Southeast Louisiana Veterans Health Care System, New Orleans, LA
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New Orleans, Louisiana, United States
Minneapolis VA Health Care System, Minneapolis, MN
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Minneapolis, Minnesota, United States
New Mexico VA Health Care System, Albuquerque, NM
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Albuquerque, New Mexico, United States
Memphis VA Medical Center, Memphis, TN
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Memphis, Tennessee, United States
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
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Boston, Massachusetts, United States
Clement J. Zablocki VA Medical Center, Milwaukee, WI
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Milwaukee, Wisconsin, United States
John D. Dingell VA Medical Center, Detroit, MI
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Detroit, Michigan, United States
Tennessee Valley Healthcare System Nashville Campus, Nashville, TN
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Nashville, Tennessee, United States