Word: trialing
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...study, published online in April by the American Journal of Psychiatry, was conducted using data from a large, government-funded trial called Sequenced Treatment Alternatives to Relieve Depression, which usually goes by the moniker STAR*D. The STAR*D project, which collected data from 2001 to 2004 at 41 U.S. psychiatric facilities, was one of the most ambitious efforts ever to understand how best to treat people with major depression. STAR*D participants comprise a powerful research sample because they are highly representative of all depressed Americans. Very few depressed people were excluded from STAR*D; only women who were...
...authors of the new paper, a team of 11 researchers led by University of Pittsburgh professor of epidemiology Stephen Wisniewski, were curious how the STAR*D group would compare with a typical group of patients selected for a run-of-the-mill drug-company trial for a new antidepressant - the very trials on which the Food and Drug Administration bases its decisions regarding new drug approval. Drawing on their own experiences in helping to conduct such trials, which have far more stringent inclusion criteria than the STAR*D group, Wisniewski and his team divided the STAR*D patients into...
...than one additional primary psychiatric disorder besides depression. All patients with multiple comorbidities - along with anyone whose depression had lasted more than two years - were excluded. Once the authors crunched all the numbers, they found that only 22% of STAR*D patients met entry criteria for a conventional antidepressant trial...
...STAR*D patients were taking citalopram, an SSRI marketed in North America as Celexa. Not surprisingly, those who met standard inclusion criteria for a clinical trial had significantly better outcomes on the drug. In the efficacy group, 52% responded to Celexa vs. 40% of the nonefficacy group. Patients in the latter group also took longer to respond and had to be readmitted to psychiatric settings more often. "Thus," the authors conclude, "current efficacy trials suggest a more optimistic outcome than is likely in practice, and the duration of adequate treatment suggested by data from efficacy trials may be too short...
...forces working with Shi'ite militias at the height of the sectarian killings. General David Petraeus, the former top U.S. commander in Iraq, and former Baghdad Ambassador Ryan Crocker repeatedly quarreled with al-Maliki on the matter throughout 2008, pressing the Prime Minister to clear the way for the trial of at least one senior Ministry of Interior official accused of orchestrating prison abuses and murders. Al-Maliki resisted the U.S. pressure and largely seemed unconcerned about investigating a myriad of cases in which Iraqi security forces, chiefly the national police, remain accused of rape, torture and murder in conjunction...