When making treatment recommendations, it is important to synthesize empirical evidence to guide clinical decisions.[41] Meta-analyses provide a quantitative synthesis of treatment trials, and provide for a more powerful examination of outcome moderators than individual treatment trials.[38; 42–46] To date, there have been seven published meta-analyses examining the efficacy of CBT,[47–49] SRIs,[35] or both interventions[50–52] for the treatment of pediatric OCD. Findings from these meta-analyses have demonstrated large treatment effects for CBT (1.45–1.98) and moderate effects for SRIs (0.46–0.48) for reducing symptom severity. While these meta-analyses are noteworthy contributions to the literature, they have several limitations, including: small sample size;[48] inclusion of open-label trials that may have inflated treatment effects;[47; 50] combined treatment effects across multiple OCD measures some which have poor treatment sensitivity in youth;[35; 52; 53] limited examination of treatment moderators;[35; 47–51] combined treatment effects across individual and group therapy formats that may have influenced moderator analyses;[51; 52] and inferred values from other placebo-controlled trials for comparison conditions.[52] Additionally, prior meta-analyses did not examine treatment response (i.e., when a patient exhibits a clinically meaningful reduction in obsessive-compulsive severity)
