SynthesisPsychological medicine2015
Cost-effectiveness of electroconvulsive therapy compared to repetitive transcranial magnetic stimulation for treatment-resistant severe depression: a decision model.
Synthesis in Psychological medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Economic evaluation of interventions for treatment-resistant depression: A systematic review.Frontiers in psychiatry · 2023Pooled it
- Repetitive Transcranial Magnetic Stimulation for People With Treatment-Resistant Depression: A Health Technology Assessment.Ontario health technology assessment series · 2021Pooled it
- Economic evaluation of an experience sampling method intervention in depression compared with treatment as usual using data from a randomized controlled trial.BMC psychiatry · 2017Trial
- A Promising Approach to Optimizing Sequential Treatment Decisions for Depression: Markov Decision Process.PharmacoEconomics · 2022Review
- Repetitive transcranial magnetic stimulation may be a cost-effective alternative to antidepressant therapy after two treatment failures in patients with major depressive disorder.BMC psychiatry · 2022Article
- rTMS combined with CBT as a next step in antidepressant non-responders: a study protocol for a randomized comparison with current antidepressant treatment approaches.BMC psychiatry · 2022Article
- Cost-utility analysis of esketamine and electroconvulsive therapy in adults with treatment-resistant depression.BMC psychiatry · 2021Article
- Cost-Utility Analysis of Electroconvulsive Therapy and Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression in Ontario.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2020Article
- Internet-Delivered Cognitive Behavioural Therapy for Major Depression and Anxiety Disorders: A Health Technology Assessment.Ontario health technology assessment series · 2019Article
- Article
- Cost-effectiveness of Electroconvulsive Therapy vs Pharmacotherapy/Psychotherapy for Treatment-Resistant Depression in the United States.JAMA psychiatry · 2018Article
- Model-Based Economic Evaluation of Treatments for Depression: A Systematic Literature Review.PharmacoEconomics - open · 2017Review
- Article
- Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment.Ontario health technology assessment series · 2017Review
- Comparison between neurostimulation techniques repetitive transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness.Patient preference and adherence · 2016Article
- The Psychiatric Patient as a Health Resource Consumer: Costs Associated with Electroconvulsive Therapy.Frontiers in psychology · 2016Article
- Cost-Effectiveness Analysis of Incretin Therapy for Type 2 Diabetes in Spain: 1.8 mg Liraglutide Versus Sitagliptin.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2015Article
- Antidepression medication improves quality of life in elderly patients with benign prostatic hyperplasia and depression.International journal of clinical and experimental medicine · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElectroconvulsive therapy (ECT) is widely applied to treat severe depression resistant to standard treatment. Results from previous studies comparing the cost-effectiveness of this technique with treatment alternatives such as repetitive transcranial magnetic stimulation (rTMS) are conflicting.
methodWe conducted a cost-effectiveness analysis comparing ECT alone, rTMS alone and rTMS followed by ECT when rTMS fails under the perspective of the Spanish National Health Service. The analysis is based on a Markov model which simulates the costs and health outcomes of individuals treated under these alternatives over a 12-month period. Data to populate this model were extracted and synthesized from a series of randomized controlled trials and other studies that have compared these techniques on the patient group of interest. We measure effectiveness using quality-adjusted life years (QALYs) and characterize the uncertainty using probabilistic sensitivity analyses.
resultsECT alone was found to be less costly and more effective than rTMS alone, while the strategy of providing rTMS followed by ECT when rTMS fails is the most expensive and effective option. The incremental cost per QALY gained of this latter strategy was found to be above the reference willingness-to-pay threshold used in these types of studies in Spain and other countries. The probability that ECT alone is the most cost-effective alternative was estimated to be around 70%.
conclusionsECT is likely to be the most cost-effective option in the treatment of resistant severe depression for a willingness to pay of €30,000 per QALY.
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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.