Evidence map›Paper›PMID 34229619›Full record

Trial reportBMC gastroenterology2021

Cost effectiveness of therapist delivered cognitive behavioural therapy and web-based self-management in irritable bowel syndrome: the ACTIB randomised trial.

Paul McCrone, Hazel Everitt, Sabine Landau, Paul Little, Felicity L Bishop, Gilly O'Reilly, Alice Sibelli, Rachel Holland, Stephanie Hughes, Sula Windgassen and 5 more

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

Trial report in BMC gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 31% 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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
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

15 authors at 4 institutions in 1 country.

Paul McCroneHealth Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. p.mccrone@greenwich.ac.uk.ORCID http://orcid.org/0000-0001-7001-4502
Hazel EverittPrimary Care and Population Sciences, University of Southampton, Southampton, UK.
Sabine LandauDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Paul LittlePrimary Care and Population Sciences, University of Southampton, Southampton, UK.
Felicity L BishopDepartment of Psychology, University of Southampton, Southampton, UK.
Gilly O'ReillyPrimary Care and Population Sciences, University of Southampton, Southampton, UK.
Alice SibelliDepartment of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Rachel HollandDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Stephanie HughesPrimary Care and Population Sciences, University of Southampton, Southampton, UK.
Sula WindgassenDepartment of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Kim GoldsmithDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Nicholas ColemanDepartment of Gastroenterology, University Hospital Southampton, Southampton, UK.
Robert LoganDepartment of Gastroenterology, King's College Hospital, London, London, UK.
Trudie ChalderDepartment of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Rona Moss-MorrisDepartment of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
King's College London · GBUniversity of Southampton · GBKing's College Hospital · GBUniversity Hospital Southampton NHS Foundation Trust · GB

Funding

Health Technology Assessment Programme 11/69
6 · The paper itself

Abstract

backgroundTelephone therapist delivered CBT (TCBT) and web-based CBT (WCBT) have been shown to be significantly more clinically effective than treatment as usual (TAU) at reducing IBS symptom severity and impact at 12 months in adults with refractory IBS. In this paper we assess the cost-effectiveness of the interventions.

methodsParticipants were recruited from 74 general practices and three gastroenterology centres in England. Interventions costs were calculated, and other service use and lost employment measured and costed for one-year post randomisation. Quality-adjusted life years (QALYs) were combined with costs to determine cost-effectiveness of TCBT and WCBT compared to TAU.

resultsTCBT cost £956 more than TAU (95% CI, £601-£1435) and generated 0.0429 more QALYs. WCBT cost £224 more than TAU (95% CI, - £11 to £448) and produced 0.029 more QALYs. Compared to TAU, TCBT had an incremental cost per QALY of £22,284 while the figure for WCBT was £7724. After multiple imputation these ratios increased to £27,436 and £17,388 respectively. Including lost employment and informal care, TCBT had costs that were on average £866 lower than TAU (95% CI, - £1133 to £2957), and WCBT had costs that were £1028 lower than TAU (95% CI, - £448 to £2580).

conclusionsTCBT and WCBT resulted in more QALYs and higher costs than TAU. Complete case analysis suggests both therapies are cost-effective from a healthcare perspective. Imputation for missing data reduces cost-effectiveness but WCTB remained cost-effective. If the reduced societal costs are included both interventions are likely to be more cost-effective. Trial registration ISRCTN44427879 (registered 18.11.13).

Indexed as

Cognitive Behavioral TherapyIrritable Bowel SyndromeSelf-ManagementAdultCost-Benefit AnalysisEnglandHumansInternetQuality-Adjusted Life YearsCognitive behavioural therapyCost-effectivenessEconomic evaluationIrritable bowel syndrome

Identifiers

PMID34229619
PMCPMC8261920
OpenAlexW3155994851

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.