Evidence map›Paper›PMID 23327355›Full record

Trial reportBMC family practice2013

Cost-effectiveness of supported self-management for CFS/ME patients in primary care.

Gerry Richardson, David Epstein, Carolyn Chew-Graham, Christopher Dowrick, Richard P Bentall, Richard K Morriss, Sarah Peters, Lisa Riste, Karina Lovell, Graham Dunn and 2 more

Open access · goldAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in BMC family practice, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 4 pooled it
1.7field-weighted citation impact, top 16% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 4 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. General medical services by non-medical health professionals: a systematic quantitative review of economic evaluations in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
    Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Review
  8. Article
  9. Article
  10. Review
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

12 authors at 5 institutions in 1 country.

Gerry RichardsonCentre for Health Economics, University of York, Hull/York Medical School,York YO10 5DD, United Kingdom.
David Epstein
Carolyn Chew-Graham
Christopher Dowrick
Richard P Bentall
Richard K Morriss
Sarah Peters
Lisa Riste
Karina Lovell
Graham Dunn
Alison J Wearden
FINE Trial Writing group on behalf of the FINE Trial group
University of Manchester · GBUniversity of York · GBBangor University · GBUniversity of Liverpool · GBUniversity of Nottingham · GB

Funding

Department of HealthMedical Research Council G0200212Medical Research Council G200212
6 · The paper itself

Abstract

backgroundNurse led self-help treatments for people with chronic fatigue syndrome/myalgic encephalitis (CFS/ME) have been shown to be effective in reducing fatigue but their cost-effectiveness is unknown.

methodsCost-effectiveness analysis conducted alongside a single blind randomised controlled trial comparing pragmatic rehabilitation (PR) and supportive listening (SL) delivered by primary care nurses, and treatment as usual (TAU) delivered by the general practitioner (GP) in North West England. A within trial analysis was conducted comparing the costs and quality adjusted life years (QALYs) measured within the time frame of the trial. 296 patients aged 18 and over with CFS/ME diagnosed using the Oxford criteria were included in the cost-effectiveness analysis.

resultsTreatment as usual is less expensive and leads to better patient outcomes compared with Supportive Listening. Treatment as usual is also less expensive than Pragmatic Rehabilitation. PR was effective at reducing fatigue in the short term, but the impact of the intervention on QALYs was uncertain. However, based on the results of this trial, PR is unlikely to be cost-effective in this patient population.

conclusionsThis analysis does not support the introduction of SL. Any benefits generated by PR are unlikely to be of sufficient magnitude to warrant recommending PR for this patient group on cost-effectiveness grounds alone. However, dissatisfaction with current treatment options means simply continuing with 'treatment as usual' in primary care is unlikely to be acceptable to patients and practitioners.

trial registrationThe trial registration number is IRCTN74156610.

Indexed as

Practice Patterns, Nurses'Activities of Daily LivingAdultAnalysis of VarianceCost-Benefit AnalysisCounselingEnglandFatigue Syndrome, ChronicHumansPrimary Health CareQuality-Adjusted Life YearsSelf CareSingle-Blind MethodSleepTreatment OutcomeYoung Adult

Identifiers

PMID23327355
PMCPMC3556109
OpenAlexW2125979206

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.