Evidence map›Paper›PMID 23103835›Full record

Trial reportJournal of medical Internet research2012

Reducing suicidal ideation: cost-effectiveness analysis of a randomized controlled trial of unguided web-based self-help.

Bregje A J van Spijker, M Cristina Majo, Filip Smit, Annemieke van Straten, Ad J F M Kerkhof

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of medical Internet research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04260607 (Initiating Ketamine in Acutely Suicidal Patients in the Emergency Department), which is not on this map. Cited by 33 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04260607 phase3terminatednot on this mapstarted 2020, after this paper: background citation

Initiating Ketamine in Acutely Suicidal Patients in the Emergency Department

TypeinterventionalSponsorNaval Medical Center Camp LejeuneRan2020 to 2022Enrolled1ConditionsSuicide, Suicide Threat, Depression SevereArmsKetamine Hydrochloride, Normal saline
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Digital interventions in mental health: evidence syntheses and economic modelling.Health technology assessment (Winchester, England) · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Bregje A J van SpijkerDepartment of Clinical Psychology and the EMGO+ Institute for Health and Care Research, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, Netherlands. baj.van.spijker@gmail.com
M Cristina Majo
Filip Smit
Annemieke van Straten
Ad J F M Kerkhof

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSuicidal ideation is highly prevalent, but often remains untreated. The Internet can be used to provide accessible interventions.

objectiveTo evaluate the cost-effectiveness of an online, unguided, self-help intervention for reducing suicidal ideation.

methodsA total of 236 adults with mild to moderate suicidal thoughts, defined as scores between 1-26 on the Beck Scale for Suicide Ideation (BSS), were recruited in the general population and randomized to the intervention (n = 116) or to a waitlist, information-only, control group (n = 120). The intervention aimed to decrease the frequency and intensity of suicidal ideation and consisted of 6 modules based on cognitive behavioral techniques. Participants in both groups had unrestricted access to care as usual. Assessments took place at baseline and 6 weeks later (post-test). All questionnaires were self-report and administered via the Internet. Treatment response was defined as a clinically significant decrease in suicidal ideation on the BSS. Total per-participant costs encompassed costs of health service uptake, participants' out-of-pocket expenses, costs stemming from production losses, and intervention costs. These were expressed in Euros (€) for the reference year 2009.

resultsAt post-test, treatment response was 35.3% and 20.8% in the experimental and control conditions, respectively. The incremental effectiveness was 0.35 - 0.21 = 0.15 (SE 0.06, P = .01). The annualized incremental costs were -€5039 per participant. Therefore, the mean incremental cost-effectiveness ratio (ICER) was estimated to be -€5039/0.15 = -€34,727 after rounding (US -$41,325) for an additional treatment response, indicating annual cost savings per treatment responder.

conclusionsThis is the first trial to indicate that online self-help to reduce suicidal ideation is feasible, effective, and cost saving. Limitations included reliance on self-report and a short timeframe (6 weeks). Therefore, replication with a longer follow-up period is recommended.

Indexed as

Cost-Benefit AnalysisInternetSuicidal IdeationAdultFemaleHumansMaleNetherlandsSurveys and Questionnaires

Identifiers

PMID23103835
PMCPMC3517339

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.