Evidence map›Paper›PMID 40165258›Full record

Trial reportBMC health services research2025

Health economic evaluation of Autism Adapted Safety Plans: findings on feasibility of tools from a pilot randomised controlled trial.

Nawaraj Bhattarai, Jane Goodwin, Mirabel Pelton, Isabel Gordon, Jacqui Rodgers, Sarah Cassidy, Janelle Wagnild, Colin Wilson, Phil Heslop, Emmanuel Ogundimu and 4 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Nawaraj BhattaraiHealth Economics Group, Population Health Science Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK. nawaraj.bhattarai@newcastle.ac.uk.
Jane GoodwinPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
Mirabel PeltonPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
Isabel GordonSchool of Psychology, University of Nottingham, Nottingham, NG7 2RG, UK.
Jacqui RodgersPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
Sarah CassidySchool of Psychology, University of Nottingham, Nottingham, NG7 2RG, UK.
Janelle WagnildDepartment of Anthropology, Durham University, Durham, DH1 3LE, UK.
Colin WilsonPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
Phil HeslopSocial Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, NE7 7XA, UK.
Emmanuel OgundimuDepartment of Mathematical Sciences, Durham University, Durham, DH1 3LE, UK.
Rory C O'ConnorSuicidal Behaviour Research Lab, School of Health & Wellbeing, University of Glasgow, Glasgow, G12 8TB, UK.
Sheena E RamsayPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
Ellen TownsendSchool of Psychology, University of Nottingham, Nottingham, NG7 2RG, UK.
Luke ValeHealth Economics Group, Population Health Science Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.

Funding

National Institute for Health Research, UK PHR NIHR129196
6 · The paper itself

Abstract

backgroundAutism Adapted Safety Plans (AASP) have been proposed to help prevent self-harm and suicidality among autistic adults. The introduction of such plans not only needs to be clinically effective but also cost-effective. The aim of this work was to establish how the cost-effectiveness of AASP could be assessed. Specifically, whether tools and techniques used to collect data for health economic evaluation of the intervention are feasible and acceptable to autistic people.

methodsA feasibility and external pilot randomised controlled trial of the AASP intervention was conducted. Autistic adults recruited from diverse locations in England and Wales were randomised to either: AASP and usual care, or usual care only. Health economics tools (bespoke and adapted) were developed and focus groups were undertaken with participants, including autistic adults (n = 15), their family members/carers (n = 5), and service providers (n = 10), to determine their acceptability and feasibility. Tools considered worth further exploration were interviewer administered to participants during the pilot trial at baseline and at 6 months. Interviewer notes were used to record any issues reported while completing the tools. Response rates on the questions and completeness of the tools, along with participant feedback in the interviewer notes was assessed.

resultsStandard Gamble and Time-Trade Off approaches to measure health status were judged inappropriate to measure health outcomes with autistic adults experiencing suicidal ideation and with a history of self-harm. Contingent valuation and discrete choice experiments were also considered inappropriate, due to the heavy cognitive burden on respondents. The EQ-5D-5L/VAS, resource utilisation questionnaire and time-travel questionnaire were considered acceptable by participants. Response and completion rates (as a percentage of all returned questionnaires) for resource utilisation questionnaire (> 85%), time-travel questionnaire (> 79%), EQ-5D-5L (> 96%) and EQ-5D-VAS (> 87%) were good in general. Participants needed clear guidance and interviewer support to enable questionnaire completion.

conclusionsIt is feasible and acceptable to collect relevant data on resource utilisation, and costs of accessing care and the EQ-5D-5L in a future definitive trial. Clear guidance and interviewer support on how to complete the questionnaires and explanations of the importance of questions to the research would help autistic participants completing the health economic tools.

trial registrationISRCTN70594445; Trial Registration Date: 06/07/2020.

Indexed as

Autistic DisorderSelf-Injurious BehaviorSuicide PreventionAdultCost-Benefit AnalysisEnglandFeasibility StudiesFemaleFocus GroupsHumansMaleMiddle AgedPilot ProjectsWalesYoung AdultAutismFeasibilityHealth economicsTools

Identifiers

PMID40165258
PMCPMC11956318

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Registered trials

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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.