Evidence map›Paper›PMID 26152298›Full record

Trial reportStroke2015

Cluster Randomized Controlled Trial: Clinical and Cost-Effectiveness of a System of Longer-Term Stroke Care.

Anne Forster, John Young, Katie Chapman, Jane Nixon, Anita Patel, Ivana Holloway, Kirste Mellish, Shamaila Anwar, Rachel Breen, Martin Knapp and 2 more

Abstract readMulticenter StudyRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 9 pooled it
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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

25 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Effects of nonpharmacological interventions on post-stroke quality of life: a systematic review, meta-analysis, and meta-regression.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
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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

12 authors.

Anne ForsterFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.). a.forster@leeds.ac.uk.
John YoungFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).
Katie ChapmanFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).
Jane NixonFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).
Anita PatelFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).
Ivana HollowayFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).
Kirste MellishFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).
Shamaila AnwarFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).
Rachel BreenFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).
Martin KnappFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).
Jenni MurrayFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).
Amanda FarrinFrom the Academic Unit of Elderly Care and Rehabilitation, Bradford Teaching Hospitals NHS Foundation Trust (A. Forster, J.Y., K.C., K.M., R.B.), Leeds Institute of Clinical Trials Research, Clinical Trials Research Unit (J.N., I.H., S.A., A. Farrin), and Leeds Institute of Health Sciences (J.M.), University of Leeds, Leeds, United Kingdom; Institute of Psychiatry, King's College London, London, United Kingdom (A.P.); and Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom (M.K.).

Funding

Department of Health RP-PG-0606-1128
6 · The paper itself

Abstract

background and purposeWe developed a new postdischarge system of care comprising a structured assessment covering longer-term problems experienced by patients with stroke and their carers, linked to evidence-based treatment algorithms and reference guides (the longer-term stroke care system of care) to address the poor longer-term recovery experienced by many patients with stroke.

methodsA pragmatic, multicentre, cluster randomized controlled trial of this system of care. Eligible patients referred to community-based Stroke Care Coordinators were randomized to receive the new system of care or usual practice. The primary outcome was improved patient psychological well-being (General Health Questionnaire-12) at 6 months; secondary outcomes included functional outcomes for patients, carer outcomes, and cost-effectiveness. Follow-up was through self-completed postal questionnaires at 6 and 12 months.

resultsThirty-two stroke services were randomized (29 participated); 800 patients (399 control; 401 intervention) and 208 carers (100 control; 108 intervention) were recruited. In intention to treat analysis, the adjusted difference in patient General Health Questionnaire-12 mean scores at 6 months was -0.6 points (95% confidence interval, -1.8 to 0.7; P=0.394) indicating no evidence of statistically significant difference between the groups. Costs of Stroke Care Coordinator inputs, total health and social care costs, and quality-adjusted life year gains at 6 months, 12 months, and over the year were similar between the groups.

conclusionsThis robust trial demonstrated no benefit in clinical or cost-effectiveness outcomes associated with the new system of care compared with usual Stroke Care Coordinator practice. CLINICAL

trial registrationURL: http://www.controlled-trials.com. Unique identifier: ISRCTN 67932305.

Indexed as

AgedAged, 80 and overCluster AnalysisCost-Benefit AnalysisFemaleFollow-Up StudiesHumansLong-Term CareMaleMiddle AgedStrokecluster randomized controlled trialcommunity health servicescost-benefit analysisquality-adjusted life yearsrehabilitationstroke

Identifiers

PMID26152298
PMCPMC4512748

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.