Trial reportTrials2015
Clinical and cost effectiveness of computer treatment for aphasia post stroke (Big CACTUS): study protocol for a randomised controlled trial.
Trial report in Trials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis 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
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Speech and language therapy for aphasia following stroke.The Cochrane database of systematic reviews · 2016Pooled it
- Self-managed, computerised word finding therapy as an add-on to usual care for chronic aphasia post-stroke: An economic evaluation.Clinical rehabilitation · 2021Trial
- Computerised speech and language therapy or attention control added to usual care for people with long-term post-stroke aphasia: the Big CACTUS three-arm RCT.Health technology assessment (Winchester, England) · 2020Trial
- Self-managed, computerised speech and language therapy for patients with chronic aphasia post-stroke compared with usual care or attention control (Big CACTUS): a multicentre, single-blinded, randomised controlled trial.The Lancet. Neurology · 2019Trial
- A feasibility randomized controlled trial of ReaDySpeech for people with dysarthria after stroke.Clinical rehabilitation · 2018Trial
- What speech and language therapy do community dwelling stroke survivors with aphasia receive in the UK?PloS one · 2018Trial
- Analyzing a Cost-Effectiveness Dataset: A Speech and Language Example for Clinicians.Seminars in speech and language · 2022Article
- Telerehabilitation for Word Retrieval Deficits in Bilinguals With Aphasia: Effectiveness and Reliability as Compared to In-person Language Therapy.Frontiers in neurology · 2021Article
- Design Considerations for Clinical Trials in Aphasia.Annals of Indian Academy of Neurology · 2020Article
- [Review on the improvements in communication skills among aphasic patients through the use of portable technology.]Revista espanola de salud publica · 2020Review
- Closing the Digital Divide in Speech, Language, and Cognitive Therapy: Cohort Study of the Factors Associated With Technology Usage for Rehabilitation.Journal of medical Internet research · 2020Article
- Progression criteria in trials with an internal pilot: an audit of publicly funded randomised controlled trials.Trials · 2019Article
- Therapist-Guided Tablet-Based Telerehabilitation for Patients With Aphasia: Proof-of-Concept and Usability Study.JMIR rehabilitation and assistive technologies · 2019Article
- Aphasia Recovery: When, How and Who to Treat?Current neurology and neuroscience reports · 2018Review
- Developing Accessible, Pictorial Versions of Health-Related Quality-of-Life Instruments Suitable for Economic Evaluation: A Report of Preliminary Studies Conducted in Canada and the United Kingdom.PharmacoEconomics - open · 2018Article
- Are pilot trials useful for predicting randomisation and attrition rates in definitive studies: A review of publicly funded trials.Clinical trials (London, England) · 2018Article
- Article
- [Aphasia: evidence-based therapy approaches].Der Nervenarzt · 2016Review
- Negotiating excess treatment costs in a clinical research trial: the good, the bad and the innovative.Trials · 2016Article
- Behavioural Activation Therapy for Depression after Stroke (BEADS): a study protocol for a feasibility randomised controlled pilot trial of a psychological intervention for post-stroke depression.Pilot and feasibility studies · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundAphasia affects the ability to speak, comprehend spoken language, read and write. One third of stroke survivors experience aphasia. Evidence suggests that aphasia can continue to improve after the first few months with intensive speech and language therapy, which is frequently beyond what resources allow. The development of computer software for language practice provides an opportunity for self-managed therapy. This pragmatic randomised controlled trial will investigate the clinical and cost effectiveness of a computerised approach to long-term aphasia therapy post stroke. METHODS/
designA total of 285 adults with aphasia at least four months post stroke will be randomly allocated to either usual care, computerised intervention in addition to usual care or attention and activity control in addition to usual care. Those in the intervention group will receive six months of self-managed word finding practice on their home computer with monthly face-to-face support from a volunteer/assistant. Those in the attention control group will receive puzzle activities, supplemented by monthly telephone calls. Study delivery will be coordinated by 20 speech and language therapy departments across the United Kingdom. Outcome measures will be made at baseline, six, nine and 12 months after randomisation by blinded speech and language therapist assessors. Primary outcomes are the change in number of words (of personal relevance) named correctly at six months and improvement in functional conversation. Primary outcomes will be analysed using a Hochberg testing procedure. Significance will be declared if differences in both word retrieval and functional conversation at six months are significant at the 5% level, or if either comparison is significant at 2.5%. A cost utility analysis will be undertaken from the NHS and personal social service perspective. Differences between costs and quality-adjusted life years in the three groups will be described and the incremental cost effectiveness ratio will be calculated. Treatment fidelity will be monitored. DISCUSSION: This is the first fully powered trial of the clinical and cost effectiveness of computerised aphasia therapy. Specific challenges in designing the protocol are considered.
trial registrationRegistered with Current Controlled Trials ISRCTN68798818 on 18 February 2014.
Indexed as
Identifiers
What OpenQuestion holds
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.