Evidence map›Paper›PMID 37924247›Full record

Trial reportHealth technology assessment (Winchester, England)2023

Online remote behavioural intervention for tics in 9- to 17-year-olds: the ORBIT RCT with embedded process and economic evaluation.

Chris Hollis, Charlotte L Hall, Kareem Khan, Marie Le Novere, Louise Marston, Rebecca Jones, Rachael Hunter, Beverley J Brown, Charlotte Sanderson, Per Andrén and 13 more

Registry-linked trialOpen access · diamondAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Health technology assessment (Winchester, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03483493 (Therapist-guided, Parent-assisted Remote Digital Behavioural Intervention for Tics in Children and Adolescents With Tourette Syndrome), which is not on this map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
4.7field-weighted citation impact, top 5% 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.

NCT03483493 nacompletednot on this map

Therapist-guided, Parent-assisted Remote Digital Behavioural Intervention for Tics in Children and Adolescents With Tourette Syndrome: an Internal Pilot Study and Single-blind Randomised Controlled Trial

TypeinterventionalSponsorNottinghamshire Healthcare NHS TrustRan2018 to 2021Enrolled224ConditionsTic Disorders, Tourette SyndromeArmsExposure Response Prevention for tics, Psychoeducation for tics
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Article
  6. Review
  7. Meta-anlaysis of Internet-based Behavior Therapy for Tic Disorder.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2025
    Article
  8. Article
  9. 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

23 authors at 6 institutions in 2 countries.

Chris HollisNIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0003-1083-6744
Charlotte L HallNIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-5412-6165
Kareem KhanNIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0003-3836-2827
Marie Le NovereResearch Department of Primary Care and Population Health and Priment CTU, University College London, London, UK.ORCID 0000-0002-9479-8599
Louise MarstonResearch Department of Primary Care and Population Health and Priment CTU, University College London, London, UK.ORCID 0000-0002-9973-1131
Rebecca JonesDivision of Psychiatry and Priment CTU, University College London, London, UK.ORCID 0000-0001-6924-0924
Rachael HunterResearch Department of Primary Care and Population Health and Priment CTU, University College London, London, UK.ORCID 0000-0002-7447-8934
Beverley J BrownNIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-1026-278X
Charlotte SandersonUCL Great Ormond Street Institute of Child Health (ICH), London, UK/Great Ormond Street Hospital for Children NHS Trust, London, UK.ORCID 0000-0001-6324-3112
Per AndrénCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID 0000-0003-1358-0166
Sophie D BennettUCL Great Ormond Street Institute of Child Health (ICH), London, UK/Great Ormond Street Hospital for Children NHS Trust, London, UK.ORCID 0000-0002-1076-7112
Liam R ChamberlainNIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-0432-9415
E Bethan DaviesNIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0003-3134-0879
Amber EvansUCL Great Ormond Street Institute of Child Health (ICH), London, UK/Great Ormond Street Hospital for Children NHS Trust, London, UK.ORCID 0000-0003-2232-3495
Natalia KouzoupiUCL Great Ormond Street Institute of Child Health (ICH), London, UK/Great Ormond Street Hospital for Children NHS Trust, London, UK.ORCID 0000-0002-1748-7156
Caitlin McKenzieNIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-7832-4388
Isobel HeymanUCL Great Ormond Street Institute of Child Health (ICH), London, UK/Great Ormond Street Hospital for Children NHS Trust, London, UK.ORCID 0000-0001-7358-9766
Joseph KilgariffDepartment of Child and Adolescent Psychiatry, Nottinghamshire Healthcare NHS Foundation Trust, South Block Level E, Queen's Medical Centre, Nottingham, UK.ORCID 0000-0002-7195-7753
Cristine GlazebrookNIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-7459-9445
David Mataix-ColsCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.ORCID 0000-0002-4545-0924
Eva SerlachiusDepartment of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.ORCID 0000-0001-7115-6422
Elizabeth MurrayResearch Department of Primary Care and Population Health and Priment CTU, University College London, London, UK.ORCID 0000-0002-8932-3695
Tara MurphyUCL Great Ormond Street Institute of Child Health (ICH), London, UK/Great Ormond Street Hospital for Children NHS Trust, London, UK.ORCID 0000-0003-1759-3562
University of Nottingham · GBGreat Ormond Street Hospital · GBUniversity College London · GBKarolinska Institutet · SELund University · SENottinghamshire Healthcare NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Behavioural therapy for tics is difficult to access, and little is known about its effectiveness when delivered online. Objective: To investigate the clinical and cost-effectiveness of an online-delivered, therapist- and parent-supported therapy for young people with tic disorders. Design: Single-blind, parallel-group, randomised controlled trial, with 3-month (primary end point) and 6-month post-randomisation follow-up. Participants were individually randomised (1 : 1), using on online system, with block randomisations, stratified by site. Naturalistic follow-up was conducted at 12 and 18 months post-randomisation when participants were free to access non-trial interventions. A subset of participants participated in a process evaluation. Setting: Two hospitals (London and Nottingham) in England also accepting referrals from patient identification centres and online self-referrals. Participants: Children aged 9-17 years (1) with Tourette syndrome or chronic tic disorder, (2) with a Yale Global Tic Severity Scale-total tic severity score of 15 or more (or > 10 with only motor or vocal tics) and (3) having not received behavioural therapy for tics in the past 12 months or started/stopped medication for tics within the past 2 months. Interventions: Either 10 weeks of online, remotely delivered, therapist-supported exposure and response prevention therapy (intervention group) or online psychoeducation (control). Outcome: Primary outcome: Yale Global Tic Severity Scale-total tic severity score 3 months post-randomisation; analysis done in all randomised patients for whom data were available. Secondary outcomes included low mood, anxiety, treatment satisfaction and health resource use. Quality-adjusted life-years are derived from parent-completed quality-of-life measures. All trial staff, statisticians and the chief investigator were masked to group allocation. Results: Two hundred and twenty-four participants were randomised to the intervention ( Harms: Two serious, unrelated adverse events occurred in the control group. Limitations: We cannot separate the effects of digital online delivery and the therapy itself. The sample was predominately white and British, limiting generalisability. The design did not compare to face-to-face services. Conclusion: Online, therapist-supported behavioural therapy for young people with tic disorders is clinically and cost-effective in reducing tics, with durable benefits extending up to 18 months. Future work: Future work should compare online to face-to-face therapy and explore how to embed the intervention in clinical practice. Trial registration: This trial is registered as ISRCTN70758207; ClinicalTrials.gov (NCT03483493). The trial is now complete. Funding: This project was funded by the National Institute for Health and Care Research (NIHR) Health and Technology Assessment programme (project number 16/19/02) and will be published in full in

Indexed as

Tic DisordersTicsAdolescentBehavior TherapyChildCost-Benefit AnalysisFemaleHumansMaleQuality of LifeSingle-Blind MethodADOLESCENTBEHAVIOUR THERAPYCHILDDIGITAL HEALTHEXPOSURE RESPONSE PREVENTIONHEALTH ECONOMIC EVALUATIONONLINEPROCESS EVALUATIONRANDOMISED CONTROLLED TRIALTIC DISORDERTICSTOURETTE SYNDROME

Identifiers

PMID37924247
PMCPMC10641713
OpenAlexW4388348432

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.