Date of Award

2021

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

Objective: The objective of this selective EBM review is to determine whether or not “Is Comprehensive Behavioral Intervention for Tics (CBIT) effective in decreasing tic severity in individuals with chronic tic disorders?”

Study Design: A systematic review of three randomized controlled trials (RCTs) published between 2010 and 2016.

Data Sources: All three RCTs were discovered using PubMed. The articles were published in English in peer-reviewed journals and selected based on applicability to the clinical question.

Outcome Measured: A reduction in tic severity was the outcome measured in all three studies using the Yale Global Tic Severity Score (YGTSS). Scores range from 0-100 with higher scores indicating stronger tic severity. The mean change from baseline was calculated once intervention was received.

Results: In the RCT led by Wilhelm et al., CBIT led to a reduction in tic severity compared with the control group (P < 0.001), indicated by a mean change from baseline of 6.2. In the RCT by Piacentini et al., CBIT led to a reduction in tic severity compared with the control group (P < 0.001), indicated by a mean change from baseline of 7.6. Lastly, Ricketts et al. demonstrated a reduction in tic severity with CBIT-VoIP (voice over internet protocol), indicated by a mean change from baseline of 7.25 with statistical significance of P < 0.01 in the CBIT treatment group.

Conclusion: All three studies in this review demonstrated that CBIT led to significantly reduced tic severity as measured by the YGTSS. This suggests CBIT is an effective and beneficial method of treatment for chronic tic disorders. Further studies should explore online administration, treatment duration, and maintenance therapy.

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