Evidence map›Paper›PMID 29449292›Full record

Trial reportBMJ open2018

Cost-effectiveness of a community-delivered multicomponent intervention compared with enhanced standard care of obese adolescents: cost-utility analysis alongside a randomised controlled trial (the HELP trial).

Monica Panca, Deborah Christie, Tim J Cole, Silvia Costa, John Gregson, Rebecca Holt, Lee D Hudson, Anthony S Kessel, Sanjay Kinra, Anne Mathiot and 5 more

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 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.

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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
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

15 authors.

Monica PancaDepartment of Primary Care and Population Health, UCL Institute of Epidemiology and Health Care, London, UK.
Deborah ChristieChild and Adolescent Psychological Medicine, University College London Hospitals, London, UK.
Tim J ColePopulation, Policy and Practice Programme, UCL Institute of Child Health, London, UK.ORCID 0000-0001-5711-8200
Silvia CostaPopulation, Policy and Practice Programme, UCL Institute of Child Health, London, UK.
John GregsonFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Rebecca HoltPopulation, Policy and Practice Programme, UCL Institute of Child Health, London, UK.
Lee D HudsonGreat Ormond Street Hospital for Children, London, UK.
Anthony S KesselPublic Health England, London, UK.
Sanjay KinraFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Anne MathiotPopulation, Policy and Practice Programme, UCL Institute of Child Health, London, UK.
Irwin NazarethDepartment of Primary Care and Population Health, UCL Institute of Epidemiology and Health Care, London, UK.
Jay WatarananPopulation, Policy and Practice Programme, UCL Institute of Child Health, London, UK.
Ian Chi Kei WongResearch Department of Practice and Policy, UCL School of Pharmacy, London, UK.
Russell M VinerPopulation, Policy and Practice Programme, UCL Institute of Child Health, London, UK.ORCID 0000-0003-3047-2247
Stephen MorrisDepartment of Applied Health Research, UCL Institute of Epidemiology and Health Care, London, UK.

Funding

Department of Health RP-PG-0608-10035Medical Research Council MR/M012069/1Medical Research Council MR/R010692/1
6 · The paper itself

Abstract

objectiveTo undertake a cost-utility analysis of a motivational multicomponent lifestyle-modification intervention in a community setting (the Healthy Eating Lifestyle Programme (HELP)) compared with enhanced standard care.

designCost-utility analysis alongside a randomised controlled trial.

settingCommunity settings in Greater London, England.

participants174 young people with obesity aged 12-19 years.

interventionsIntervention participants received 12 one-to-one sessions across 6 months, addressing lifestyle behaviours and focusing on motivation to change and self-esteem rather than weight change, delivered by trained graduate health workers in community settings. Control participants received a single 1-hour one-to-one nurse-delivered session providing didactic weight-management advice.

main outcome measuresMean costs and quality-adjusted life years (QALYs) per participant over a 1-year period using resource use data and utility values collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated and non-parametric bootstrapping was conducted to generate a cost-effectiveness acceptability curve (CEAC).

resultsMean intervention costs per participant were £918 for HELP and £68 for enhanced standard care. There were no significant differences between the two groups in mean resource use per participant for any type of healthcare contact. Adjusted costs were significantly higher in the intervention group (mean incremental costs for HELP vs enhanced standard care £1003 (95% CI £837 to £1168)). There were no differences in adjusted QALYs between groups (mean QALYs gained 0.008 (95% CI -0.031 to 0.046)). The ICER of the HELP versus enhanced standard care was £120 630 per QALY gained. The CEAC shows that the probability that HELP was cost-effective relative to the enhanced standard care was 0.002 or 0.046, at a threshold of £20 000 or £30 000 per QALY gained.

conclusionsWe did not find evidence that HELP was more effective than a single educational session in improving quality of life in a sample of adolescents with obesity. HELP was associated with higher costs, mainly due to the extra costs of delivering the intervention and therefore is not cost-effective. TRIAL REGISTRATION NUMBER: ISRCTN9984011.

Indexed as

Cost-Benefit AnalysisHealthy LifestyleMotivationQuality-Adjusted Life YearsStandard of CareAdolescentAdultBody WeightChildCosts and Cost AnalysisDiet, HealthyFemaleHealth EducationHealth PromotionHumansLondonchildhood obesitycost-effectivecost-utilityqaly

Identifiers

PMID29449292
PMCPMC6124607

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

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.