Evidence map›Paper›PMID 42574010›Full record

Trial reportJAMA network open2026

Remote Multicomponent Rehabilitation and Cost-Effectiveness in Survivors of Critical Illness.

Mandana Zanganeh, Brenda O'Neill, Judy M Bradley, Bronwen Connolly, Julie Bruce, Martin Underwood, Mariam Ratna, Ranjit Lall, Chen Ji, Jill Costley and 15 more

Abstract readMulticenter StudyPragmatic Clinical Trial
In one paragraph

Trial report in JAMA network open, 2026. 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

25 authors.

Mandana ZanganehWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Brenda O'NeillInstitute of Nursing and Health Research, School of Health Sciences, Ulster University, Belfast, United Kingdom.
Judy M BradleyWellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.
Bronwen ConnollyWellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.
Julie BruceWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Martin UnderwoodWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Mariam RatnaWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Ranjit LallWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Chen JiWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Jill CostleyInstitute of Nursing and Health Research, School of Health Sciences, Ulster University, Belfast, United Kingdom.
Rachel ClarkeUniversity Hospitals Plymouth NHS Trust, Derriford Hospital, Plymouth, United Kingdom.
Paul DarkDivision of Immunology, Immunity to Infection and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
Orla DuffyInstitute of Nursing and Health Research, School of Health Sciences, Ulster University, Belfast, United Kingdom.
Penelope FirshmanSurrey and Sussex Healthcare NHS Trust, Redhill, United Kingdom.
Nigel D HartWellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.
Annette HendersonInstitute of Nursing and Health Research, School of Health Sciences, Ulster University, Belfast, United Kingdom.
Katherine JonesWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Roger KenyonPatient Advisory Group, iRehab Trial Management Group, Preston, United Kingdom.
Darren MurphyInstitute of Nursing and Health Research, School of Health Sciences, Ulster University, Belfast, United Kingdom.
Gavin D PerkinsWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Kerry RaynesWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Ella TerblancheSchool of Health Rehabilitation Sciences, Health Sciences University, Bournemouth, United Kingdom.
Daniel F McAuleyWellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.
Jason MadanWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
iRehab Trial Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: The cost-effectiveness of remote rehabilitation for survivors following critical illness after intensive care unit (ICU) care is unknown. Objective: To evaluate the cost-effectiveness of remote multicomponent rehabilitation compared with standard care following discharge from hospital after an ICU admission. Design, Setting, and Participants: This economic evaluation was conducted within a pragmatic, multicenter, assessor-blinded trial comparing remote rehabilitation delivered online with standard care after discharge from ICU from both National Health Service (NHS) and Personal Social Services (PSS) and societal perspectives over a 6-month time horizon. The trial was conducted from December 2022 to November 2025. The setting was 52 NHS hospitals in the United Kingdom. Participants were adults (aged ≥18 years) within 12 weeks of discharge from hospital that included an ICU admission for critical illness, requiring mechanical ventilation for 48 hours or longer. Interventions: A remotely delivered rehabilitation program or standard care. Main Outcomes and Measures: Costs including using questionnaires and microcosting approach (in 2024 UK pounds sterling) and quality-adjusted life-years (QALYs), derived directly from trial data, were calculated per group and reported in terms of incremental cost per QALY gained. Results: A total of 429 participants (245 men [57%]; mean [SD] age, 55.4 [13.9] years) were enrolled, including 231 (54%) in the intervention group and 198 (46%) in the standard group. From a UK NHS-PSS perspective, the rehabilitation intervention was associated with increased mean costs (£1250; 95% CI, £562-£1938) and QALYs (0.023; 95% CI, 0.007-0.040) per participant, compared with the standard care group. Incremental cost-effectiveness ratio (ICER) was £54 034 per QALY. The probability of rehabilitation intervention being cost-effective was 3% and 11% at UK willingness-to-pay thresholds of £20 000 and £30 000 per QALY, respectively. The intervention was cost-effective for patients with mechanical ventilation for 7 days or less (ICER, £21 476 per QALY) or if a societal perspective was adopted (ICER, £6341 per QALY). Conclusions and Relevance: In this economic analysis, among ICU survivors overall, a remotely delivered multicomponent rehabilitation program was not cost-effective from a UK NHS-PSS perspective. Cost-effectiveness was more favorable from a societal perspective and for patients receiving mechanical ventilation for 7 days or less. For rehabilitation interventions to be both clinically and cost-effective a precision medicine approach to medical and psychosocial health care interventions is needed once patients are home from hospital.

Indexed as

Critical IllnessSurvivorsTelemedicineAdultAgedCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansIntensive Care UnitsMaleMiddle AgedQuality-Adjusted Life YearsUnited Kingdom

Identifiers

PMID42574010
PMCPMC13458876

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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.