{"id":63771,"date":"2016-03-01T16:18:57","date_gmt":"2016-03-01T21:18:57","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=63771"},"modified":"2016-03-01T16:50:06","modified_gmt":"2016-03-01T21:50:06","slug":"words-and-music","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2016\/03\/01\/words-and-music\/","title":{"rendered":"words and music…"},"content":{"rendered":"\n
It is either fashionable or required to end articles with a few comments about the limitations of the study. In this case, I’m going to start with the limitations; then summarize my previous musings on the topic; then say what the topic actually is that has these limitations and musings:<\/div>\n
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Limitations<\/font><\/strong><\/u>
Several limitations of this study require comment. First, the conditions of a randomized trial like RAISE-ETP may not be generalizable to real-world practice since all sites that volunteered for RAISE-ETP were capable and motivated to successfully implement a comprehensive, integrated care FEP program with existing non-research sources of funding.<\/font> As a result, CC sites most likely offered a level of FEP care that was superior to usual FEP treatment in the US, thus minimizing observed differences between NAV and usual treatment. In several other RCTs of FEP programs, rates of hospitalization among control groups were 37% to 71% over 12 months, 1.5 to 3.5 times greater than the 20% seen in the first 12 months for CC in this study. This difference suggests that the lack of more favorable NAV-CC differences in inpatient care and costs may reflect an exceptionally good performance at keeping hospital utilization low at CC sites in this study. If CC subjects in the present study had performed similarly to control groups in previous trials cited above, the differentially greater costs associated with NAV might have been reduced to zero or might even have been reversed to as much as $7000 in savings. Generalizability of these results is thus uncertain as RAISE-ETC may have artificially increased CC effectiveness and reduced CC costs….<\/div>\n<\/blockquote>\n
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Translation?<\/font><\/strong><\/em> My first encounter with the NIMH RAISE [Recovery After Initial Schizophrenic Episode] study was Dr. Insel’s blog touting the fact that SAMHSA had announced the availability of Block Grants to States for setting up early intervention programs in Schizophrenia, and was using the methodology of the ongoing NIMH RAISE study as a template for that effort. Dr. Insel saw that as moving research from the bench to the bedside – an oft quoted motto for Translational Medicine [<\/sup>Director’s Blog: From Research to Practice<\/a>].<\/sup><\/div>\n