Evidence map›Paper›PMID 29228517›Full record

Trial reportThe Journal of clinical psychiatry

Cost-Effectiveness of Internet-Based Cognitive-Behavioral Treatment for Bulimia Nervosa: Results of a Randomized Controlled Trial.

Hunna J Watson, Nicole McLagan, Stephanie C Zerwas, Ross D Crosby, Michele D Levine, Cristin D Runfola, Christine M Peat, Markus Moessner, Benjamin Zimmer, Sara M Hofmeier and 4 more

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

Trial report in The Journal of clinical psychiatry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00877786 (Optimizing Technology in the Treatment of Bulimia Nervosa), which is not on this map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 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.

NCT00877786 nacompletednot on this map

Optimizing Technology in the Treatment of Bulimia Nervosa

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2008 to 2016Enrolled196ConditionsBulimia NervosaArmsCognitive Behavioral Group Therapy
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Uses of Virtual Care in Primary Care: Scoping Review.Journal of medical Internet research · 2025
    Article
  5. Article
  6. Article
  7. Review
  8. 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

14 authors.

Hunna J WatsonDepartment of Psychiatry, The University of North Carolina at Chapel Hill, CB #7160, 101 Manning Dr, Chapel Hill, NC 27599. hunna_watson@med.unc.edu.
Nicole McLaganEating Disorders Program, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
Stephanie C ZerwasDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Ross D CrosbyNeuropsychiatric Research Institute, Fargo, North Dakota, USA.
Michele D LevineDepartment of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Cristin D RunfolaDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Christine M PeatDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Markus MoessnerCenter for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany.
Benjamin ZimmerCenter for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany.
Sara M HofmeierDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Robert M HamerDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Marsha D MarcusEating Disorders Program, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
Cynthia M BulikDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Scott J CrowDepartment of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

Funding

UNC Clinical and Translational Science AwardUL1TR000083 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI RUNGE, MARSCHALL S. · 2012 to 2013
$11.6M
Optimizing Technology in the Treatment of Bulimia NervosaR01MH080065 · NIMH · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BULIK, CYNTHIA M · 2008 to 2012
$3.2M
Postdoctoral Research Training in Eating DisordersT32MH076694 · NIMH · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BULIK, CYNTHIA M · 2007 to 2016
$1.8M
Developmental Psychopathology of Restrictive and Binge Eating in ChildhoodK01MH100435 · NIMH · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ZERWAS, STEPHANIE CHRISTINE · 2013 to 2015
$488k
NCATS NIH HHS UL1 TR000083NIMH NIH HHS K01 MH100435NIMH NIH HHS R01 MH080065NIMH NIH HHS T32 MH076694
6 · The paper itself

Abstract

objectiveTo evaluate the cost-effectiveness of Internet-based cognitive-behavioral therapy for bulimia nervosa (CBT-BN) compared to face-to-face delivery of CBT-BN.

methodsThis study is a planned secondary analysis of data from a randomized clinical trial. Participants were 179 adults (98% female, mean age = 28 years) meeting DSM-IV criteria for bulimia nervosa who were randomized to group face-to-face or group Internet-based CBT-BN for 16 sessions during 20 weeks. The cost-effectiveness analysis was conducted from a third-party payor perspective, and a partial societal perspective analysis was conducted to investigate cost-utility (ie, cost per gain in quality-adjusted life-years) and patient out-of-pocket travel-related costs. Net health care costs were calculated from protocol and nonprotocol health care services using third-party payor cost estimates. The primary outcome measure in the clinical trial was abstinence from binge eating and purging, and the trial start and end dates were 2008 and 2016.

resultsThe mean cost per abstinent patient at posttreatment was $7,757 (95% confidence limit [CL], $4,515, $13,361) for face-to-face and $11,870 (95% CL, $6,486, $22,188) for Internet-based CBT-BN, and at 1-year follow-up was $16,777 (95% CL, $10,298, $27,042) for face-to-face and $14,561 (95% CL, $10,165, $21,028) for Internet-based CBT-BN. There were no statistically significant differences between treatment arms in cost-effectiveness or cost-utility at posttreatment or 1-year follow-up. Out-of-pocket patient costs were significantly higher for face-to-face (mean [95% CL] = $178 [$127, $140]) than Internet-based ($50 [$50, $50]) therapy.

conclusionsThird-party payor cost-effectiveness of Internet-based CBT-BN is comparable with that of an accepted standard. Internet-based dissemination of CBT-BN may be a viable alternative for patients geographically distant from specialist eating disorder services who have an unmet need for treatment.

trial registrationClinicalTrials.gov identifier: NCT00877786​.

Indexed as

InternetAdultBulimia NervosaCognitive Behavioral TherapyCost-Benefit AnalysisFemaleHealth Care CostsHumansMalePsychotherapy, GroupQuality-Adjusted Life YearsTelemedicineTreatment OutcomeYoung Adult

Identifiers

PMID29228517
PMCPMC5837958

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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.