Evidence map›Paper›PMID 36561218›Full record

ArticlePrinciples and practice of clinical research (2015)2022

Cost-Effectiveness Analysis to Inform Randomized Controlled Trial Design in Chronic Pain Research: Methods for Guiding Decisions on the Addition of a Run-In Period.

Haley Rafferty, Elisa Rocha, Paola Gonzalez-Mego, Clara L Ramos, Mirret M El-Hagrassy, Muhammed E Gunduz, Elif Uygur-Kucukseymen, Hanan Zehry, Swapnali S Chaudhari, Paulo Ep Teixeira and 8 more

Open access · diamondAbstract read
In one paragraph

Article in Principles and practice of clinical research (2015), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 25% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

18 authors at 6 institutions in 1 country.

Haley RaffertyNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Elisa RochaNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Paola Gonzalez-MegoNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Clara L RamosNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Mirret M El-HagrassyNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Muhammed E GunduzNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Elif Uygur-KucukseymenNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Hanan ZehryNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Swapnali S ChaudhariNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Paulo Ep TeixeiraNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Gleysson R RosaNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Ana L ZaninottoNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Christopher ConnorHarvard Medical School, Boston, MA, USA.
Uri EdenBoston University, Boston, MA, USA.
Ciro Ramos-EstebanezCase Western Reserve University, Cleveland, Ohio.
Felipe FregniNeuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Charlestown, MA, USA.
Laura DipietroHighland Instruments, Inc. Cambridge, MA, USA.
Timothy WagnerHighland Instruments, Inc. Cambridge, MA, USA.
Massachusetts General Hospital · USSpaulding Rehabilitation Hospital · USHarvard University · USHighland Community College - Illinois · USBrigham and Women's Hospital · USCase Western Reserve University · US

Funding

Noninvasive Brain Stimulation for Treating Addiction (Supplement)R44DA049685 · NIDA · HIGHLAND INSTRUMENTS, INC. · PI DIPIETRO, LAURA, WAGNER, TIMOTHY ANDREW · 2019 to 2024
$3.0M
Pan-neuronal functional imaging and anesthesiaR35GM145319 · NIGMS · BRIGHAM AND WOMEN'S HOSPITAL · PI Christopher W Connor · 2022 to 2026
$1.8M
Noninvasive brain stimulation for pain suppressionR44AT008637 · NCCIH · HIGHLAND INSTRUMENTS, INC. · PI WAGNER, TIMOTHY ANDREW · 2015 to 2017
$1.7M
Optimizing Technology and Treatment for Non Specific Chronic Low Back PainR44AG055360 · NIA · HIGHLAND INSTRUMENTS, INC. · PI DIPIETRO, LAURA, WAGNER, TIMOTHY ANDREW · 2016 to 2020
$1.7M
Enhancing Physical Therapy: Noninvasive Brain Stimulation System for Treating Carpal Tunnel SyndromeR44AR076885 · NIAMS · HIGHLAND INSTRUMENTS, INC. · PI DIPIETRO, LAURA, WAGNER, TIMOTHY ANDREW · 2019 to 2023
$1.7M
Optimization of Non Invasive Brain Stimulation for Diabetic Neuropathic PainR44DK117710 · NIDDK · HIGHLAND INSTRUMENTS, INC. · PI DIPIETRO, LAURA, WAGNER, TIMOTHY ANDREW · 2018 to 2022
$1.0M
NCCIH NIH HHS R44 AT008637NIAMS NIH HHS R44 AR076885NIA NIH HHS R44 AG055360NIDA NIH HHS R44 DA049685NIDDK NIH HHS R44 DK117710NIGMS NIH HHS R35 GM145319
6 · The paper itself

Abstract

Introduction: Run-In (RI) periods can be used to improve the validity of randomized controlled trials (RCTs), but their utility in Chronic Pain (CP) RCTs is debated. Cost-effectiveness analysis (CEA) methods are commonly used in evaluating the results of RCTs, but they are seldom used for designing RCTs. We present a step-by-step overview to objectively design RCTs via CEA methods and specifically determine the cost effectiveness of a RI period in a CP RCT. Methods: We applied the CEA methodology to data obtained from several noninvasive brain stimulation CP RCTs, specifically focusing on (1) defining the CEA research question, (2) identifying RCT phases and cost ingredients, (3) discounting, (4) modeling the stochastic nature of the RCT, and (5) performing sensitivity analyses. We assessed the average cost-effectiveness ratios and incremental cost effectiveness ratios of varied RCT designs and the impact on cost-effectiveness by the inclusion of a RI period vs. No-Run-In (NRI) period. Results: We demonstrated the potential impact of varying the number of institutions, number of patients that could be accommodated per institution, cost and effectiveness discounts, RCT component costs, and patient adherence characteristics on varied RI and NRI RCT designs. In the specific CP RCT designs that we analyzed, we demonstrated that lower patient adherence, lower baseline assessment costs, and higher treatment costs all necessitated the inclusion of an RI period to be cost-effective compared to NRI RCT designs. Conclusions: Clinical trialists can optimize CP RCT study designs and make informed decisions regarding RI period inclusion/exclusion via CEA methods.

Indexed as

Chronic Pain Trialscost-effectiveness analysis (CEA)NeuromodulationNoninvasive Brain Stimulationrandomized controlled trial design (RCT design)Run-In Period

Identifiers

PMID36561218
PMCPMC9769699
OpenAlexW4298050678

What OpenQuestion holds

Textmetadata
LicenceTDM
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.