Does this study (and other results of ACT) mean that the IBH-PC study is not needed? No - important as ACT is, there are a lot of limitations and unanswered questions that we will address in IBH-PC.
This analysis did not have a control group. IBH-PC has randomized concurrent controls.
Because it studied only patients with high scores on the PHQ-9 at baseline, it is subject to regression to the mean. IBH-PC will not select for high scores at baseline.
It had 475 patients from five practices, all in one state. IBH-PC will enroll 3,000 patients from 40 practices all over the country.
It addressed only depression. IBH-PC will study a broad range of overlapping medical and behavioral conditions.
All of these issues weaken the conclusions that can be drawn and limit the ability of policy- and decision-makers to get fully behind integration. So, we soldier on!
- Ben Littenberg