ArticleJMIR mental health2019
Economic Evaluation of an Internet-Based Stress Management Intervention Alongside a Randomized Controlled Trial.
Article in JMIR mental health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The Cost-Effectiveness of Digitally Supported Mental Well-Being Prevention and Promotion Targeting Nonclinical Adult Populations: Systematic Review.JMIR mental health · 2025Pooled it
- Cost-effectiveness of Internet Interventions Compared With Treatment as Usual for People With Mental Disorders: Systematic Review and Meta-analysis of Randomized Controlled Trials.Journal of medical Internet research · 2023Pooled it
- Digital interventions in mental health: evidence syntheses and economic modelling.Health technology assessment (Winchester, England) · 2022Pooled it
- Trial
- A Universal Digital Stress Management Intervention for Employees: Randomized Controlled Trial with Health-Economic Evaluation.Journal of medical Internet research · 2024Trial
- A three-armed randomised controlled trial investigating the comparative impact of guidance on the efficacy of a web-based stress management intervention and health impairing and promoting mechanisms of prevention.BMC public health · 2021Trial
- Guided Internet-Based Cognitive Behavioral Therapy for Insomnia: Health-Economic Evaluation From the Societal and Public Health Care Perspective Alongside a Randomized Controlled Trial.Journal of medical Internet research · 2021Trial
- Cost-Effectiveness of Therapist-Guided Internet-Based Cognitive Behavioral Therapy for Stress-Related Disorders: Secondary Analysis of a Randomized Controlled Trial.Journal of medical Internet research · 2019Trial
- Research progress on chronic stress stimulation and gastric cancer metastasis.Discover oncology · 2025Review
- Systematic review of economic evaluations for internet- and mobile-based interventions for mental health problems.NPJ digital medicine · 2022Article
- A Technology-Assisted Telephone Intervention for Work-Related Stress Management: Pilot Randomized Controlled Trial.Journal of medical Internet research · 2022Article
- Comparative effectiveness of guided internet-based stress management training versus established in-person group training in employees - study protocol for a pragmatic, randomized, non-inferiority trial.BMC public health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWork-related stress is widespread among employees and associated with high costs for German society. Internet-based stress management interventions (iSMIs) are effective in reducing such stress. However, evidence for their cost-effectiveness is scant.
objectiveThe aim of this study was to assess the cost-effectiveness of a guided iSMI for employees.
methodsA sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale≥22) was assigned to either the iSMI or a waitlist control condition (WLC) with unrestricted access to treatment as usual. Participants were recruited in Germany in 2013 and followed through 2014, and data were analyzed in 2017. The iSMI consisted of 7 sessions plus 1 booster session. It was based on problem-solving therapy and emotion regulation techniques. Costs were measured from the societal perspective, including all direct and indirect medical costs. We performed a cost-effectiveness analysis and a cost-utility analysis relating costs to a symptom-free person and quality-adjusted life years (QALYs) gained, respectively. Sampling uncertainty was handled using nonparametric bootstrapping (N=5000).
resultsWhen the society is not willing to pay anything to get an additional symptom-free person (eg, willingness-to-pay [WTP]=€0), there was a 70% probability that the intervention is more cost-effective than WLC. This probability rose to 85% and 93% when the society is willing to pay €1000 and €2000, respectively, for achieving an additional symptom-free person. The cost-utility analysis yielded a 76% probability that the intervention is more cost-effective than WLC at a conservative WTP threshold of €20,000 (US $25,800) per QALY gained.
conclusionsOffering an iSMI to stressed employees has an acceptable likelihood of being cost-effective compared with WLC.
trial registrationGerman Clinical Trials Register DRKS00004749; https://www.drks.de/DRKS00004749. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/1471-2458-13-655.
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