Evidence map›Paper›PMID 29471478›Full record

Trial reportJournal of the National Cancer Institute2018

Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors: A Randomized Controlled Trial.

Robert Zachariae, Ali Amidi, Malene F Damholdt, Cecilie D R Clausen, Jesper Dahlgaard, Holly Lord, Frances P Thorndike, Lee M Ritterband

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the National Cancer Institute, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06614647 (RESPONSE), which is not on this map. Cited by 112 papers, 26 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
112citing papers in PubMed, 26 pooled it
9.5field-weighted citation impact, top 2% of its field
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.

NCT06614647 narecruitingnot on this mapstarted 2024, after this paper: background citation

RESPONSE: Colorectal Cancer Survivors' Follow-up Care - Now Digital and Need-based: A National Interventional Effectiveness Trial for Stage I and II Patients

TypeinterventionalSponsorUniversity of AarhusRan2024 to 2030Enrolled400ConditionsColorectal Cancer, Quality of Life, SurvivorshipArmsRecurrence monitoring with circulating tumor DNA (ctDNA) as a high risk biomarker, Monitoring for late adverse effects with electronic patient reported outcome measures (ePROMs), Systematic treatment of organ-specific late effects and/or biopsychosocial late effects, Digital care-guide for long-term follow-up after cancer treatment
3 · Its place in the literature

Who cites it

112 citing papers in PubMed, 26 syntheses or guidelines pooled it, 218 citations in OpenAlex.

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  3. Effectiveness of eHealth interventions in long-term follow-up care for breast and gynecological cancer survivors: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
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  18. Guideline
  19. Effectiveness of telemedicine-based psychosocial intervention for breast cancer patients: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
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52 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Robert ZachariaeUnit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital and Department of Psychology, Aarhus University, Aarhus, Denmark.
Ali AmidiUnit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital and Department of Psychology, Aarhus University, Aarhus, Denmark.
Malene F DamholdtUnit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital and Department of Psychology, Aarhus University, Aarhus, Denmark.
Cecilie D R ClausenUnit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital and Department of Psychology, Aarhus University, Aarhus, Denmark.
Jesper DahlgaardFaculty of Health Sciences, VIA University College, Aarhus, Denmark.
Holly LordCenter for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA.
Frances P ThorndikeBeHealth Solutions, LLC, Charlottesville, VA.
Lee M RitterbandCenter for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA.
Aarhus University Hospital · DKUniversity of Virginia · USVIA University College · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Insomnia is two to three times more prevalent in cancer survivors than in the general population, where it is estimated to be 10% to 20%. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia, but meeting survivor needs remains a challenge. Internet-delivered CBT-I (iCBT-I) has been shown efficacious in otherwise healthy adults. We tested the efficacy of iCBT-I in breast cancer survivors with clinically significant sleep disturbance. Methods: Women from a national sample of Danish breast cancer survivors who experienced clinically significant sleep disturbance were randomly allocated to iCBT-I or waitlist control (55:45). The fully automated iCBT-I program consisted of six cores. Online measures of insomnia severity, sleep quality, and fatigue were collected at baseline, postintervention (nine weeks), and follow-up (15 weeks). Online sleep diaries were completed over two-week periods pre- and postintervention. Intention-to-treat analyses (time × group interactions) were conducted with mixed linear models and corrected for multiple outcomes. All statistical tests were two-sided. Results: A total of 255 women were randomly allocated to iCBT-I (n = 133) or waitlist control (n = 122). Statistically significant (P ≤ .02) time × group interactions were found for all sleep-related outcomes from pre- to postintervention. Effect sizes (Cohen's d) ranged from 0.33 (95% confidence interval [CI] = 0.06 to 0.61) for wake after sleep onset to 1.17 (95% CI = 0.87 to 1.47) for insomnia severity. Improvements were maintained for outcomes measured at follow-up (d = 0.66-1.10). Conclusions: iCBT-I appears to be effective in breast cancer survivors, with additional benefit in terms of reduced fatigue. This low-cost treatment could be incorporated in cancer rehabilitation programs.

Indexed as

Cancer SurvivorsInternetAdolescentAdultAgedBreast NeoplasmsCognitive Behavioral TherapyDenmarkFemaleHumansIntention to Treat AnalysisMiddle AgedSleepSleep Initiation and Maintenance DisordersTelemedicineTreatment Outcome

Identifiers

PMID29471478
PMCPMC6093474
OpenAlexW2972485842

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.