Evidence map›Paper›PMID 32781987›Full record

Trial reportBMC neurology2020

Cost-effectiveness of the PDSAFE personalised physiotherapy intervention for fall prevention in Parkinson's: an economic evaluation alongside a randomised controlled trial.

Yiqiao Xin, Ann Ashburn, Ruth M Pickering, Kim Chivers Seymour, Sophia Hulbert, Carolyn Fitton, Dorit Kunkel, Ioana Marian, Helen C Roberts, Sarah E Lamb and 4 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 pooled it
2.7field-weighted citation impact, top 6% 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.

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

5 citing papers in PubMed, 3 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Health-related quality of life in Parkinson's disease: systematic review and meta-analysis of EuroQol (EQ-5D) utility scores.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024
    Pooled it
  2. Pooled it
  3. Interventions for preventing falls in Parkinson's disease.The Cochrane database of systematic reviews · 2022
    Pooled it
  4. Review
  5. 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

14 authors at 5 institutions in 1 country.

Yiqiao XinHealth Economics and Health Technology Assessment (HEHTA), Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank gardens, Glasgow, G12 8RZ, UK.
Ann AshburnSchool of Health Science, University of Southampton, Southampton, UK.
Ruth M PickeringFaculty of Medicine, University of Southampton, Southampton, UK.
Kim Chivers SeymourSchool of Health Science, University of Southampton, Southampton, UK.
Sophia HulbertSchool of Health Science, University of Southampton, Southampton, UK.
Carolyn FittonSchool of Health Science, University of Southampton, Southampton, UK.
Dorit KunkelSchool of Health Science, University of Southampton, Southampton, UK.
Ioana MarianFaculty of Medicine, University of Southampton, Southampton, UK.
Helen C RobertsFaculty of Medicine, University of Southampton, Southampton, UK.
Sarah E LambCentre for Statistics in Medicine, Oxford Clinical Trials Research Unit (OCTRU), University of Oxford, Oxford, UK.
Victoria A GoodwinCollege of Medicine and Health, University of Exeter, Exeter, UK.
Lynn RochesterClinical Ageing Research Unit, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.
Emma McIntoshHealth Economics and Health Technology Assessment (HEHTA), Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank gardens, Glasgow, G12 8RZ, UK. Emma.McIntosh@glasgow.ac.uk.
PDSAFE Collaborative group
University of Southampton · GBUniversity of Glasgow · GBNewcastle University · GBUniversity of Exeter · GBUniversity of Oxford · GB

Funding

Department of Health 10/57/20National Institute for Health Research project number 10/57/21
6 · The paper itself

Abstract

backgroundPDSAFE is an individually-tailored, physiotherapist-delivered, balance, strength and strategy training programme aimed at preventing falls among people with Parkinson's. We evaluated the cost-effectiveness of PDSAFE compared with usual care for people with Parkinson's at higher risk of falling, from a UK National Health Service and Personal Social Service perspective.

methodsResource use and quality of life data (EQ-5D-3L) were collected from 238 participants randomised to the PDSAFE intervention and 236 participants randomised to control, at baseline, 3 months, 6 months (primary outcome), and 12 months. Adjusted cost and quality-adjusted life-years (QALYs) were estimated using generalised linear models and uncertainty estimated using a non-parametric bootstrap.

resultsOver 6 months, the PDSAFE intervention was associated with an incremental cost of £925 (95% CI £428 to £1422) and a very small and statistically insignificant QALY gain of 0.008 (95% CI - 0.006 to 0.021). The resulting incremental cost-effectiveness ratio (ICER) was £120,659 per QALY and the probability of the intervention being cost-effective at a UK threshold of £30,000/QALY was less than 1%. The ICER varied substantially across subgroups although no subgroup had an ICER lower than the £30,000 threshold. The result was sensitive to the time horizon with the ICER reducing to £55,176 per QALY when adopting a 12-month time horizon and assuming a sustained treatment effect on QoL, nevertheless, the intervention was still not cost-effective according to the current UK threshold.

conclusionsEvidence from this trial suggests that the PDSAFE intervention is unlikely to be cost-effective at 6 months. The 12-month analysis suggested that the intervention became closer to being cost-effective if quality of life effects were sustained beyond the intervention period, however this would require confirmation. Further research, including qualitative studies, should be conducted to better understand the treatment effect of physiotherapy and its impact on quality of life in people with Parkinson's given existing mixed evidence on this topic.

trial registrationISRCTN48152791. Registered 17 April 2014. http://www.isrctn.com/ISRCTN48152791.

Indexed as

Accidental FallsAgedCost-Benefit AnalysisFemaleHumansMaleParkinson DiseasePhysical Therapy ModalitiesPrecision MedicineQuality-Adjusted Life YearsQuality of LifeCostCost-effectivenessParkinson’sPhysiotherapistQuality of life

Identifiers

PMID32781987
PMCPMC7418432
OpenAlexW3048642956

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.