Evidence map›Paper›PMID 37018151›Full record

Trial reportRheumatology (Oxford, England)2023

Cost-effectiveness of cognitive behavioural and personalized exercise interventions for reducing fatigue in inflammatory rheumatic diseases.

Huey Yi Chong, Paul McNamee, Eva-Maria Bachmair, Kathryn Martin, Lorna Aucott, Neeraj Dhaun, Emma Dures, Richard Emsley, Stuart R Gray, Elizabeth Kidd and 12 more

Open access · hybridAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Rheumatology (Oxford, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 21% 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, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  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

22 authors at 11 institutions in 1 country.

Huey Yi ChongHealth Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.ORCID 0000-0002-0768-1844
Paul McNameeHealth Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Eva-Maria BachmairInstitute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
Kathryn MartinAberdeen Centre for Arthritis and Musculoskeletal Health (Academic Primary Care Group), University of Aberdeen, Aberdeen, UK.
Lorna AucottCentre of Healthcare and Randomised Trials (CHaRT), Health Service Research Unit, University of Aberdeen, Aberdeen, UK.
Neeraj DhaunCentre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh/British Heart Foundation Centre of Research Excellence, Edinburgh, UK.ORCID 0000-0001-9128-6603
Emma DuresFaculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
Richard EmsleyDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID 0000-0002-1218-675X
Stuart R GrayInstitute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.ORCID 0000-0001-8969-9636
Elizabeth KiddDepartment of Rheumatology, Freeman's Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Vinod KumarDepartment of Rheumatology, Ninewells Hospital, NHS Tayside, Dundee, UK.
Karina LovellSchool of Health Sciences, University of Manchester, Manchester, UK.
Graeme MacLennanCentre of Healthcare and Randomised Trials (CHaRT), Health Service Research Unit, University of Aberdeen, Aberdeen, UK.ORCID 0000-0002-1039-5646
John NorrieEdinburgh Clinical Trials Unit, University of Edinburgh, Western General Hospital, Edinburgh, UK.
Lorna PaulSchool of Health and Life Science, Glasgow Caledonian University, Glasgow, UK.
Jonathan PackhamPhysiotherapy and Paramedicine, Haywood Rheumatology Centre, Stoke-on-Trent, UK.
Stuart H RalstonRheumatology and Bone Disease, University of Edinburgh, Western General Hospital, Edinburgh, UK.
Stefan SiebertInstitute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.ORCID 0000-0002-1802-7311
Alison WeardenSchool of Health Sciences, University of Manchester, Manchester, UK.
Gary MacfarlaneAberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UK.ORCID 0000-0003-2322-3314
Neil BasuInstitute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
LIFT Study Group
University of Aberdeen · GBNewcastle upon Tyne Hospitals NHS Foundation Trust · GBUniversity of Glasgow · GBWestern General Hospital · GBGlasgow Caledonian University · GBManchester Academic Health Science Centre · GBUniversity of the West of England · GBBritish Heart Foundation · GBHaywood Community Hospital · GBKing's College London · GBNHS Tayside · GB

Funding

Arthritis Research UK 21175Chief Scientist Office HSRU1Versus Arthritis
6 · The paper itself

Abstract

objectivesTo estimate the cost-effectiveness of a cognitive behavioural approach (CBA) or a personalized exercise programme (PEP), alongside usual care (UC), in patients with inflammatory rheumatic diseases who report chronic, moderate to severe fatigue.

methodsA within-trial cost-utility analysis was conducted using individual patient data collected within a multicentre, three-arm randomized controlled trial over a 56-week period. The primary economic analysis was conducted from the UK National Health Service (NHS) perspective. Uncertainty was explored using cost-effectiveness acceptability curves and sensitivity analysis.

resultsComplete-case analysis showed that, compared with UC, both PEP and CBA were more expensive [adjusted mean cost difference: PEP £569 (95% CI: £464, £665); CBA £845 (95% CI: £717, £993)] and, in the case of PEP, significantly more effective [adjusted mean quality-adjusted life year (QALY) difference: PEP 0.043 (95% CI: 0.019, 0.068); CBA 0.001 (95% CI: -0.022, 0.022)]. These led to an incremental cost-effectiveness ratio (ICER) of £13 159 for PEP vs UC, and £793 777 for CBA vs UC. Non-parametric bootstrapping showed that, at a threshold value of £20 000 per QALY gained, PEP had a probability of 88% of being cost-effective. In multiple imputation analysis, PEP was associated with significant incremental costs of £428 (95% CI: £324, £511) and a non-significant QALY gain of 0.016 (95% CI: -0.003, 0.035), leading to an ICER of £26 822 vs UC. The estimates from sensitivity analyses were consistent with these results.

conclusionThe addition of a PEP alongside UC is likely to provide a cost-effective use of health care resources.

Indexed as

Rheumatic DiseasesState MedicineCognitionCost-Benefit AnalysisExercise TherapyFatigueHumansQuality-Adjusted Life Yearscognitive behaviouralcost-effectivenessfatigueinflammatory rheumatic diseasespersonalized exerciseremote delivery

Identifiers

PMID37018151
PMCPMC10691924
OpenAlexW4362601160

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.