Evidence map›Paper›PMID 29654096›Full record

SynthesisHeart (British Cardiac Society)2018

Cost-effectiveness of cardiac rehabilitation: a systematic review.

Gemma E Shields, Adrian Wells, Patrick Doherty, Anthony Heagerty, Deborah Buck, Linda M Davies

3 registry-linked trialsAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Heart (British Cardiac Society), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 147 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
147citing papers in PubMed, 13 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.

NCT04556227 narecruitingnot on this mapstarted 2024, after this paper: background citation

Simultaneous Recumbent Cycling and Cognitive Training on Cognition in Intensive Care Unit Survivors: a Randomized Control Trial

TypeinterventionalSponsorUniversity of Missouri, Kansas CityRan2024 to 2025Enrolled50ConditionsDelirium, Impaired CognitionArmsSimultaneous Cycle/Cognitive Training
NCT05285969 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Motivational Interview for Cardiac Rehabilitation in Acute Myocardial Infarction: A Randomized Controlled Trial in the Primary Healthcare Area.

TypeinterventionalSponsorConsorci d'Atenció Primària de Salut de l'EixampleRan2022 to 2025Enrolled284ConditionsMyocardial Infarction, AcuteArmsMotivational interview, Active Comparator: Standard care group
NCT05532605 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Effects of Mindfulness Based Therapy on Patients Perception of Illness and Depression in Cardiac Rehabilitation Phase-i

TypeinterventionalSponsorRiphah International UniversityRan2022 to 2023Enrolled48ConditionsCoronary Artery StenosisArmscardiac rehabilitation phase I protocols, Cardiac rehab phase I protocols + Mindfullness base therapy
3 · Its place in the literature

Who cites it

147 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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87 more citing papers are in PubMed but not listed here.

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

6 authors.

Gemma E ShieldsCentre for Health Economics, University of Manchester, Manchester, UK.ORCID 0000-0003-4869-7524
Adrian WellsSchool of Psychological Sciences, University of Manchester, Manchester, UK.
Patrick DohertyDepartment of Health Sciences, University of York, York, UK.
Anthony HeagertyInstitute of Cardiovascular Sciences, University of Manchester, Manchester, UK.
Deborah BuckCentre for Health Economics, University of Manchester, Manchester, UK.
Linda M DaviesCentre for Health Economics, University of Manchester, Manchester, UK.

Funding

Department of Health RP-PG-1211-20011
6 · The paper itself

Abstract

Patients may be offered cardiac rehabilitation (CR), a supervised programme often including exercises, education and psychological care, following a cardiac event, with the aim of reducing morbidity and mortality. Cost-constrained healthcare systems require information about the best use of budget and resources to maximise patient benefit. We aimed to systematically review and critically appraise economic studies of CR and its components. In January 2016, validated electronic searches of the National Health Service Economic Evaluation Database (NHS EED), Health Technology Assessment, PsycINFO, MEDLINE and Embase databases were run to identify full economic evaluations published since 2001. Two levels of screening were used and explicit inclusion criteria were applied. Prespecified data extraction and critical appraisal were performed using the NHS EED handbook and Drummond checklist. The majority of studies concluded that CR was cost-effective versus no CR (incremental cost-effectiveness ratios (ICERs) ranged from $1065 to $71 755 per quality-adjusted life-year (QALY)). Evidence for specific interventions within CR was varied; psychological intervention ranged from dominant (cost saving and more effective) to $226 128 per QALY, telehealth ranged from dominant to $588 734 per QALY and while exercise was cost-effective across all relevant studies, results were subject to uncertainty. Key drivers of cost-effectiveness were risk of subsequent events and hospitalisation, hospitalisation and intervention costs, and utilities. This systematic review of studies evaluates the cost-effectiveness of CR in the modern era, providing a fresh evidence base for policy-makers. Evidence suggests that CR is cost-effective, especially with exercise as a component. However, research is needed to determine the most cost-effective design of CR.

Indexed as

Exercise TherapyCardiac RehabilitationCost-Benefit AnalysisHealth Care RationingHumanscardiac rehabilitationhealth care economicssystemic review

Identifiers

PMID29654096
PMCPMC6109236

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.