Trial reportBMJ open2019
Economic evaluation of a phase III international randomised controlled trial of very early mobilisation after stroke (AVERT).
Trial report in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis 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
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- [Organization and costs of stroke care in outpatient settings: Systematic review].Atencion primaria · 2023Pooled it
- Early rehabilitation initiation after aneurysmal subarachnoid haemorrhage: evaluation of mortality and functional outcomes.European stroke journal · 2026Article
- Efficacy of Early Mobilization in Stroke Patients in Relation to Quality of Life and Level of Dependency: A Systematic Review.Healthcare (Basel, Switzerland) · 2025Review
- Article
- Economic analysis of digital motor rehabilitation technologies: a systematic review.Health economics review · 2024Review
- Cost-Effectiveness of Monitoring Patients Post-Stroke With Mobile ECG During the Hospital Stay.Journal of the American Heart Association · 2022Article
- Early mobilization implementation for critical ill patients: A cross-sectional multi-center survey about knowledge, attitudes, and perceptions of critical care nurses.International journal of nursing sciences · 2022Article
- Telemedicine for Stroke: Quantifying the Long-Term National Costs and Health Benefits.Frontiers in neurology · 2021Article
- Cost and cost-effectiveness of early inpatient rehabilitation after stroke varies with initial disability: the Czech Republic perspective.International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
objectivesWhile very early mobilisation (VEM) intervention for stroke patients was shown not to be effective at 3 months, 12 month clinical and economical outcomes remain unknown. The aim was to assess cost-effectiveness of a VEM intervention within a phase III randomised controlled trial (RCT).
designAn economic evaluation alongside a RCT, and detailed resource use and cost analysis over 12 months post-acute stroke.
settingMulti-country RCT involved 58 stroke centres.
participants2104 patients with acute stroke who were admitted to a stroke unit.
interventionA very early rehabilitation intervention within 24 hours of stroke onset
methodsCost-utility analyses were undertaken according to pre-specified protocol measuring VEM against usual care (UC) based on 12 month outcomes. The analysis was conducted using both health sector and societal perspectives. Unit costs were sourced from participating countries. Details on resource use (both health and non-health) were sourced from cost case report form. Dichotomised modified Rankin Scale (mRS) scores (0 to 2 vs 3 to 6) and quality adjusted-life years (QALYs) were used to compare the treatment effect of VEM and UC. The base case analysis was performed on an intention-to-treat basis and 95% CI for cost and QALYs were estimated by bootstrapping. Sensitivity analysis were conducted to examine the robustness of base case results.
resultsVEM and UC groups were comparable in the quantity of resource use and cost of each component. There were no differences in the probability of achieving a favourable mRS outcome (0.030, 95% CI -0.022 to 0.082), QALYs (0.013, 95% CI -0.041 to 0.016) and cost (AUD1082, 95% CI -$2520 to $4685 from a health sector perspective or AUD102, 95% CI -$6907 to $7111, from a societal perspective including productivity cost). Sensitivity analysis achieved results with mostly overlapped CIs.
conclusionsVEM and UC were associated with comparable costs, mRS outcome and QALY gains at 12 months. Compared with to UC, VEM is unlikely to be cost-effective. The long-term data collection during the trial also informed resource use and cost of care post-acute stroke across five participating countries. TRIAL REGISTRATION NUMBER: ACTRN12606000185561; Results.
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