Trial reportFamily practice2025
Cost-effectiveness of a corticosteroid injection versus exercise therapy for shoulder pain in general practice (SIX-Shoulder Study): a randomized controlled trial.
Trial report in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundShoulder pain often results in functional limitations leading to substantial societal and healthcare costs. Guidelines recommend a corticosteroid injection or exercise therapy, but long-term comparative cost-effectiveness remains unclear. This study examined the cost-effectiveness of these two treatments over 12 months in patients with shoulder pain presenting in Dutch primary care.
methodsA randomized controlled trial was conducted with patients consulting for a new episode of shoulder pain. Participants were randomly assigned to a corticosteroid injection or a 12-week physiotherapist-led exercise therapy program. Participants completed questionnaires at baseline, 6 weeks, and 3, 6, 9, and 12 months. The primary outcome was incremental costs per quality-adjusted life year (QALY) gained over 12 months, analyzed with the incremental cost-effectiveness ratio (ICER). QALY was measured using the EuroQol Five-Dimensional Questionnaire (EQ-5D-5L) score.
resultsA total of 183 participants were included, with 91 participants in the injection group and 92 in the exercise therapy group. The incremental costs and QALY for the exercise group were, respectively, €428 (95% CI: -1825 to 2682) and 0.02957 (95% CI: -0.0299 to 0.0891), resulting in an ICER of €14 489 (95% CI: -1 698 053 to 1 727 032) per QALY gained. With a willingness-to-pay threshold of 50 000 the cost-effectiveness acceptability curve showed a probability of 70% of cost-effectiveness for exercise therapy.
conclusionsFor patients with shoulder pain, the exercise therapy group has a probability of 70% to be cost-effective compared to the injection group over a 12-month follow-up with an ICER of €14 489 (95% CI: -1 698 053 to 1 727 032) at a willingness-to-pay threshold of €50 000 per QALY. CLINICAL
trial registrationregistered in the Netherlands Trial Registry (NL-OMON52854).
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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.