and then provided to the treating clinician who reviewed
the list with the child and parent to determine its severity,
association with study treatments, and actions to be
taken by the study team. This 2-stage strategy was used
to ensure standardized ascertainment of adverse events
across the four treatment conditions.
In response to FDA black box warning regarding the
risk for suicidality events associated with SSRIs,[38] and
in consultation with NIMH and the CAMS Data Safety
and Monitoring Board, a harm to self and others questionnaire
was developed and implemented. The participant’s
treating clinician administered this form at each
treatment session to document the onset or change in
harm-related ideation or behavior.
To ensure cross-site uniformity in the management of
clinically emergent situations, CAMS followed procedures
implemented in other pediatric comparative trials
[39,40]. Up to 2 additional treatment sessions ("ASAP
sessions”) were permitted per participant in both Phase
I and II to manage any newly emergent clinical needs
and facilitate participant retention. Participants whose
clinical needs required more than two ASAP sessions
per study Phase were “prematurely terminated” by the
site team and referred for additional treatment outside
the study