In Reply: The comments by Ms Schwan and Dr Hallberg highlight measurement and analytic issues in anxiety treatment research. In the study, escitalopram was superior to placebo in cumulative response for GAD in older adults. This primary outcome analysis used the Clinical Global Impression-Improvement scale. Our use of this scale was based on its global assessment of clinical response using all available clinical data, including rating scale data, the patient's report, and the rater's observations. It has clear cut points for a binary outcome such as response, and it had adequate interrater reliability in this study.
Lenze EJ. Escitalopram Treatment of Generalized Anxiety Disorder in Older Adults—Reply. JAMA. 2009;301(19):1987-1988. doi:10.1001/jama.2009.652