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Author Han, S.-Y.; Hong, Z.-Y.; Xie, Y.-H.; Zhao, Y.; Xu, X. url  doi
openurl 
  Title Therapeutic effect of Chinese herbal medicines for post stroke recovery: A traditional and network meta-analysis Type of Study
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 49 Pages e8830  
  Keywords Adult; Aged; Aged, 80 and over; Drugs, Chinese Herbal/*therapeutic use; Female; Humans; Male; Middle Aged; Network Meta-Analysis; Phytotherapy/*methods; Randomized Controlled Trials as Topic; Stroke/*drug therapy; Stroke Rehabilitation/*methods; Treatment Outcome  
  Abstract BACKGROUND: Stroke is a condition with high morbidity and mortality, and 75% of stroke survivors lose their ability to work. Stroke is a burden to the family and society. The purpose of this study was to evaluate the effectiveness of Chinese herbal patent medicines in the treatment of patients after the acute phase of a stroke. METHODS: We searched the following databases through August 2016: PubMed, Embase, Cochrane library, China Knowledge Resource Integrated Database (CNKI), China Science Periodical Database (CSPD), and China Biology Medicine disc (CBMdisc) for studies that evaluated Chinese herbal patent medicines for post stroke recovery. A random-effect model was used to pool therapeutic effects of Chinese herbal patent medicines on stroke recovery. Network meta-analysis was used to rank the treatment for each Chinese herbal patent medicine. RESULTS: In our meta-analysis, we evaluated 28 trials that included 2780 patients. Chinese herbal patent medicines were effective in promoting recovery after stroke (OR, 3.03; 95% CI: 2.53-3.64; P < .001). Chinese herbal patent medicines significantly improved neurological function defect scores when compared with the controls (standard mean difference [SMD], -0.89; 95% CI, -1.44 to -0.35; P = .001). Chinese herbal patent medicines significantly improved the Barthel index (SMD, 0.73; 95% CI, 0.53-0.94; P < .001) and the Fugl-Meyer assessment scores (SMD, 0.60; 95% CI, 0.34-0.86; P < .001). In the network analysis, MLC601, Shuxuetong, and BuchangNaoxintong were most likely to improve stroke recovery in patients without acupuncture. Additionally, Mailuoning, Xuesaitong, BuchangNaoxintong were the patented Chinese herbal medicines most likely to improve stroke recovery when combined with acupuncture. CONCLUSIONS: Our research suggests that the Chinese herbal patent medicines were effective for stroke recovery. The most effective treatments for stroke recovery were MLC601, Shuxuetong, and BuchangNaoxintong. However, to clarify the specific effective ingredients of Chinese herbal medicines, a well-designed study is warranted.  
  Address Department of Internal Medicine, Shanghai Fengxian District Chinese Medicine Hospital, Shanghai, China  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29245245; PMCID:PMC5728860 Approved no  
  Call Number OCOM @ refbase @ Serial 2768  
Permanent link to this record
 

 
Author Han, S.-Y.; Hong, Z.-Y.; Xie, Y.-H.; Zhao, Y.; Xu, X. url  doi
openurl 
  Title Therapeutic effect of Chinese herbal medicines for post stroke recovery: A traditional and network meta-analysis Type of Study
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 49 Pages e8830  
  Keywords Adult; Aged; Aged, 80 and over; Drugs, Chinese Herbal/*therapeutic use; Female; Humans; Male; Middle Aged; Network Meta-Analysis; Phytotherapy/*methods; Randomized Controlled Trials as Topic; Stroke/*drug therapy; Stroke Rehabilitation/*methods; Treatment Outcome  
  Abstract BACKGROUND: Stroke is a condition with high morbidity and mortality, and 75% of stroke survivors lose their ability to work. Stroke is a burden to the family and society. The purpose of this study was to evaluate the effectiveness of Chinese herbal patent medicines in the treatment of patients after the acute phase of a stroke. METHODS: We searched the following databases through August 2016: PubMed, Embase, Cochrane library, China Knowledge Resource Integrated Database (CNKI), China Science Periodical Database (CSPD), and China Biology Medicine disc (CBMdisc) for studies that evaluated Chinese herbal patent medicines for post stroke recovery. A random-effect model was used to pool therapeutic effects of Chinese herbal patent medicines on stroke recovery. Network meta-analysis was used to rank the treatment for each Chinese herbal patent medicine. RESULTS: In our meta-analysis, we evaluated 28 trials that included 2780 patients. Chinese herbal patent medicines were effective in promoting recovery after stroke (OR, 3.03; 95% CI: 2.53-3.64; P < .001). Chinese herbal patent medicines significantly improved neurological function defect scores when compared with the controls (standard mean difference [SMD], -0.89; 95% CI, -1.44 to -0.35; P = .001). Chinese herbal patent medicines significantly improved the Barthel index (SMD, 0.73; 95% CI, 0.53-0.94; P < .001) and the Fugl-Meyer assessment scores (SMD, 0.60; 95% CI, 0.34-0.86; P < .001). In the network analysis, MLC601, Shuxuetong, and BuchangNaoxintong were most likely to improve stroke recovery in patients without acupuncture. Additionally, Mailuoning, Xuesaitong, BuchangNaoxintong were the patented Chinese herbal medicines most likely to improve stroke recovery when combined with acupuncture. CONCLUSIONS: Our research suggests that the Chinese herbal patent medicines were effective for stroke recovery. The most effective treatments for stroke recovery were MLC601, Shuxuetong, and BuchangNaoxintong. However, to clarify the specific effective ingredients of Chinese herbal medicines, a well-designed study is warranted.  
  Address Department of Internal Medicine, Shanghai Fengxian District Chinese Medicine Hospital, Shanghai, China  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29245245; PMCID:PMC5728860 Approved no  
  Call Number OCOM @ refbase @ Serial 2809  
Permanent link to this record
 

 
Author Han, S.-Y.; Hong, Z.-Y.; Xie, Y.-H.; Zhao, Y.; Xu, X. url  doi
openurl 
  Title Therapeutic effect of Chinese herbal medicines for post stroke recovery: A traditional and network meta-analysis Type of Study
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 49 Pages e8830  
  Keywords Adult; Aged; Aged, 80 and over; Drugs, Chinese Herbal/*therapeutic use; Female; Humans; Male; Middle Aged; Network Meta-Analysis; Phytotherapy/*methods; Randomized Controlled Trials as Topic; Stroke/*drug therapy; Stroke Rehabilitation/*methods; Treatment Outcome  
  Abstract BACKGROUND: Stroke is a condition with high morbidity and mortality, and 75% of stroke survivors lose their ability to work. Stroke is a burden to the family and society. The purpose of this study was to evaluate the effectiveness of Chinese herbal patent medicines in the treatment of patients after the acute phase of a stroke. METHODS: We searched the following databases through August 2016: PubMed, Embase, Cochrane library, China Knowledge Resource Integrated Database (CNKI), China Science Periodical Database (CSPD), and China Biology Medicine disc (CBMdisc) for studies that evaluated Chinese herbal patent medicines for post stroke recovery. A random-effect model was used to pool therapeutic effects of Chinese herbal patent medicines on stroke recovery. Network meta-analysis was used to rank the treatment for each Chinese herbal patent medicine. RESULTS: In our meta-analysis, we evaluated 28 trials that included 2780 patients. Chinese herbal patent medicines were effective in promoting recovery after stroke (OR, 3.03; 95% CI: 2.53-3.64; P < .001). Chinese herbal patent medicines significantly improved neurological function defect scores when compared with the controls (standard mean difference [SMD], -0.89; 95% CI, -1.44 to -0.35; P = .001). Chinese herbal patent medicines significantly improved the Barthel index (SMD, 0.73; 95% CI, 0.53-0.94; P < .001) and the Fugl-Meyer assessment scores (SMD, 0.60; 95% CI, 0.34-0.86; P < .001). In the network analysis, MLC601, Shuxuetong, and BuchangNaoxintong were most likely to improve stroke recovery in patients without acupuncture. Additionally, Mailuoning, Xuesaitong, BuchangNaoxintong were the patented Chinese herbal medicines most likely to improve stroke recovery when combined with acupuncture. CONCLUSIONS: Our research suggests that the Chinese herbal patent medicines were effective for stroke recovery. The most effective treatments for stroke recovery were MLC601, Shuxuetong, and BuchangNaoxintong. However, to clarify the specific effective ingredients of Chinese herbal medicines, a well-designed study is warranted.  
  Address Department of Internal Medicine, Shanghai Fengxian District Chinese Medicine Hospital, Shanghai, China  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29245245; PMCID:PMC5728860 Approved no  
  Call Number OCOM @ refbase @ Serial 2850  
Permanent link to this record
 

 
Author Han, S.-Y.; Hong, Z.-Y.; Xie, Y.-H.; Zhao, Y.; Xu, X. url  doi
openurl 
  Title Therapeutic effect of Chinese herbal medicines for post stroke recovery: A traditional and network meta-analysis Type of Study
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 49 Pages e8830  
  Keywords Adult; Aged; Aged, 80 and over; Drugs, Chinese Herbal/*therapeutic use; Female; Humans; Male; Middle Aged; Network Meta-Analysis; Phytotherapy/*methods; Randomized Controlled Trials as Topic; Stroke/*drug therapy; Stroke Rehabilitation/*methods; Treatment Outcome  
  Abstract BACKGROUND: Stroke is a condition with high morbidity and mortality, and 75% of stroke survivors lose their ability to work. Stroke is a burden to the family and society. The purpose of this study was to evaluate the effectiveness of Chinese herbal patent medicines in the treatment of patients after the acute phase of a stroke. METHODS: We searched the following databases through August 2016: PubMed, Embase, Cochrane library, China Knowledge Resource Integrated Database (CNKI), China Science Periodical Database (CSPD), and China Biology Medicine disc (CBMdisc) for studies that evaluated Chinese herbal patent medicines for post stroke recovery. A random-effect model was used to pool therapeutic effects of Chinese herbal patent medicines on stroke recovery. Network meta-analysis was used to rank the treatment for each Chinese herbal patent medicine. RESULTS: In our meta-analysis, we evaluated 28 trials that included 2780 patients. Chinese herbal patent medicines were effective in promoting recovery after stroke (OR, 3.03; 95% CI: 2.53-3.64; P < .001). Chinese herbal patent medicines significantly improved neurological function defect scores when compared with the controls (standard mean difference [SMD], -0.89; 95% CI, -1.44 to -0.35; P = .001). Chinese herbal patent medicines significantly improved the Barthel index (SMD, 0.73; 95% CI, 0.53-0.94; P < .001) and the Fugl-Meyer assessment scores (SMD, 0.60; 95% CI, 0.34-0.86; P < .001). In the network analysis, MLC601, Shuxuetong, and BuchangNaoxintong were most likely to improve stroke recovery in patients without acupuncture. Additionally, Mailuoning, Xuesaitong, BuchangNaoxintong were the patented Chinese herbal medicines most likely to improve stroke recovery when combined with acupuncture. CONCLUSIONS: Our research suggests that the Chinese herbal patent medicines were effective for stroke recovery. The most effective treatments for stroke recovery were MLC601, Shuxuetong, and BuchangNaoxintong. However, to clarify the specific effective ingredients of Chinese herbal medicines, a well-designed study is warranted.  
  Address Department of Internal Medicine, Shanghai Fengxian District Chinese Medicine Hospital, Shanghai, China  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29245245; PMCID:PMC5728860 Approved no  
  Call Number OCOM @ refbase @ Serial 2891  
Permanent link to this record
 

 
Author Han, S.-Y.; Hong, Z.-Y.; Xie, Y.-H.; Zhao, Y.; Xu, X. url  doi
openurl 
  Title Therapeutic effect of Chinese herbal medicines for post stroke recovery: A traditional and network meta-analysis Type of Study
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 49 Pages e8830  
  Keywords Adult; Aged; Aged, 80 and over; Drugs, Chinese Herbal/*therapeutic use; Female; Humans; Male; Middle Aged; Network Meta-Analysis; Phytotherapy/*methods; Randomized Controlled Trials as Topic; Stroke/*drug therapy; Stroke Rehabilitation/*methods; Treatment Outcome  
  Abstract BACKGROUND: Stroke is a condition with high morbidity and mortality, and 75% of stroke survivors lose their ability to work. Stroke is a burden to the family and society. The purpose of this study was to evaluate the effectiveness of Chinese herbal patent medicines in the treatment of patients after the acute phase of a stroke. METHODS: We searched the following databases through August 2016: PubMed, Embase, Cochrane library, China Knowledge Resource Integrated Database (CNKI), China Science Periodical Database (CSPD), and China Biology Medicine disc (CBMdisc) for studies that evaluated Chinese herbal patent medicines for post stroke recovery. A random-effect model was used to pool therapeutic effects of Chinese herbal patent medicines on stroke recovery. Network meta-analysis was used to rank the treatment for each Chinese herbal patent medicine. RESULTS: In our meta-analysis, we evaluated 28 trials that included 2780 patients. Chinese herbal patent medicines were effective in promoting recovery after stroke (OR, 3.03; 95% CI: 2.53-3.64; P < .001). Chinese herbal patent medicines significantly improved neurological function defect scores when compared with the controls (standard mean difference [SMD], -0.89; 95% CI, -1.44 to -0.35; P = .001). Chinese herbal patent medicines significantly improved the Barthel index (SMD, 0.73; 95% CI, 0.53-0.94; P < .001) and the Fugl-Meyer assessment scores (SMD, 0.60; 95% CI, 0.34-0.86; P < .001). In the network analysis, MLC601, Shuxuetong, and BuchangNaoxintong were most likely to improve stroke recovery in patients without acupuncture. Additionally, Mailuoning, Xuesaitong, BuchangNaoxintong were the patented Chinese herbal medicines most likely to improve stroke recovery when combined with acupuncture. CONCLUSIONS: Our research suggests that the Chinese herbal patent medicines were effective for stroke recovery. The most effective treatments for stroke recovery were MLC601, Shuxuetong, and BuchangNaoxintong. However, to clarify the specific effective ingredients of Chinese herbal medicines, a well-designed study is warranted.  
  Address Department of Internal Medicine, Shanghai Fengxian District Chinese Medicine Hospital, Shanghai, China  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29245245; PMCID:PMC5728860 Approved no  
  Call Number OCOM @ refbase @ Serial 2932  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2441  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2482  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2523  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2564  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2605  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2647  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2688  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2728  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2769  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2810  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2851  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2892  
Permanent link to this record
 

 
Author Essex, H.; Parrott, S.; Atkin, K.; Ballard, K.; Bland, M.; Eldred, J.; Hewitt, C.; Hopton, A.; Keding, A.; Lansdown, H.; Richmond, S.; Tilbrook, H.; Torgerson, D.; Watt, I.; Wenham, A.; Woodman, J.; MacPherson, H. url  doi
openurl 
  Title An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS) Type of Study
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0178918  
  Keywords Acupuncture/economics/*methods; Age Factors; Chronic Pain/*therapy; *Cost-Benefit Analysis; Female; Humans; Male; *Movement; Musculoskeletal Manipulations/economics/*methods; Neck Pain/*therapy; Primary Health Care  
  Abstract OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were pound451 for acupuncture and pound667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = pound18,767/QALY bootstrapped 95% CI pound4,426 to pound74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of pound20,000/QALY ( pound25,101/QALY bootstrapped 95% CI – pound150,208 to pound248,697) but may be at pound30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.  
  Address Department of Health Sciences, University of York, York, United Kingdom  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29211741; PMCID:PMC5718562 Approved no  
  Call Number OCOM @ refbase @ Serial 2933  
Permanent link to this record
 

 
Author Ju, Z.Y.; Wang, K.; Cui, H.S.; Yao, Y.; Liu, S.M.; Zhou, J.; Chen, T.Y.; Xia, J. url  doi
openurl 
  Title Acupuncture for neuropathic pain in adults Type of Study Journal Article
  Year 2017 Publication The Cochrane Database of Systematic Reviews Abbreviated Journal Cochrane Database Syst Rev  
  Volume 12 Issue Pages Cd012057  
  Keywords *Acupuncture Therapy; Adult; Analgesics/therapeutic use; Chronic Pain/*therapy; Drugs, Chinese Herbal/therapeutic use; Humans; Inositol/therapeutic use; Middle Aged; Neuralgia/*therapy; Nimodipine/therapeutic use; Pain Measurement; Quality of Life; Randomized Controlled Trials as Topic; Vitamin B 12/analogs & derivatives/therapeutic use  
  Abstract BACKGROUND: Neuropathic pain may be caused by nerve damage, and is often followed by changes to the central nervous system. Uncertainty remains regarding the effectiveness and safety of acupuncture treatments for neuropathic pain, despite a number of clinical trials being undertaken. OBJECTIVES: To assess the analgesic efficacy and adverse events of acupuncture treatments for chronic neuropathic pain in adults. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, four Chinese databases, ClinicalTrials.gov and World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) on 14 February 2017. We also cross checked the reference lists of included studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) with treatment duration of eight weeks or longer comparing acupuncture (either given alone or in combination with other therapies) with sham acupuncture, other active therapies, or treatment as usual, for neuropathic pain in adults. We searched for studies of acupuncture based on needle insertion and stimulation of somatic tissues for therapeutic purposes, and we excluded other methods of stimulating acupuncture points without needle insertion. We searched for studies of manual acupuncture, electroacupuncture or other acupuncture techniques used in clinical practice (such as warm needling, fire needling, etc). DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. The primary outcomes were pain intensity and pain relief. The secondary outcomes were any pain-related outcome indicating some improvement, withdrawals, participants experiencing any adverse event, serious adverse events and quality of life. For dichotomous outcomes, we calculated risk ratio (RR) with 95% confidence intervals (CI), and for continuous outcomes we calculated the mean difference (MD) with 95% CI. We also calculated number needed to treat for an additional beneficial outcome (NNTB) where possible. We combined all data using a random-effects model and assessed the quality of evidence using GRADE to generate 'Summary of findings' tables. MAIN RESULTS: We included six studies involving 462 participants with chronic peripheral neuropathic pain (442 completers (251 male), mean ages 52 to 63 years). The included studies recruited 403 participants from China and 59 from the UK. Most studies included a small sample size (fewer than 50 participants per treatment arm) and all studies were at high risk of bias for blinding of participants and personnel. Most studies had unclear risk of bias for sequence generation (four out of six studies), allocation concealment (five out of six) and selective reporting (all included studies). All studies investigated manual acupuncture, and we did not identify any study comparing acupuncture with treatment as usual, nor any study investigating other acupuncture techniques (such as electroacupuncture, warm needling, fire needling).One study compared acupuncture with sham acupuncture. We are uncertain if there is any difference between the two interventions on reducing pain intensity (n = 45; MD -0.4, 95% CI -1.83 to 1.03, very low-quality evidence), and neither group achieved 'no worse than mild pain' (visual analogue scale (VAS, 0-10) average score was 5.8 and 6.2 respectively in the acupuncture and sham acupuncture groups, where 0 = no pain). There was limited data on quality of life, which showed no clear difference between groups. Evidence was not available on pain relief, adverse events or other pre-defined secondary outcomes for this comparison.Three studies compared acupuncture alone versus other therapies (mecobalamin combined with nimodipine, and inositol). Acupuncture may reduce the risk of 'no clinical response' to pain than other therapies (n = 209; RR 0.25, 95% CI 0.12 to 0.51), however, evidence was not available for pain intensity, pain relief, adverse events or any of the other secondary outcomes.Two studies compared acupuncture combined with other active therapies (mecobalamin, and Xiaoke bitong capsule) versus other active therapies used alone. We found that the acupuncture combination group had a lower VAS score for pain intensity (n = 104; MD -1.02, 95% CI -1.09 to -0.95) and improved quality of life (n = 104; MD -2.19, 95% CI -2.39 to -1.99), than those receiving other therapy alone. However, the average VAS score of the acupuncture and control groups was 3.23 and 4.25 respectively, indicating neither group achieved 'no worse than mild pain'. Furthermore, this evidence was from a single study with high risk of bias and a very small sample size. There was no evidence on pain relief and we identified no clear differences between groups on other parameters, including 'no clinical response' to pain and withdrawals. There was no evidence on adverse events.The overall quality of evidence is very low due to study limitations (high risk of performance, detection, and attrition bias, and high risk of bias confounded by small study size) or imprecision. We have limited confidence in the effect estimate and the true effect is likely to be substantially different from the estimated effect. AUTHORS' CONCLUSIONS: Due to the limited data available, there is insufficient evidence to support or refute the use of acupuncture for neuropathic pain in general, or for any specific neuropathic pain condition when compared with sham acupuncture or other active therapies. Five studies are still ongoing and seven studies are awaiting classification due to the unclear treatment duration, and the results of these studies may influence the current findings.  
  Address College of Acumox and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29197180 Approved no  
  Call Number OCOM @ refbase @ Serial 2442  
Permanent link to this record
 

 
Author Ju, Z.Y.; Wang, K.; Cui, H.S.; Yao, Y.; Liu, S.M.; Zhou, J.; Chen, T.Y.; Xia, J. url  doi
openurl 
  Title Acupuncture for neuropathic pain in adults Type of Study Journal Article
  Year 2017 Publication The Cochrane Database of Systematic Reviews Abbreviated Journal Cochrane Database Syst Rev  
  Volume 12 Issue Pages Cd012057  
  Keywords *Acupuncture Therapy; Adult; Analgesics/therapeutic use; Chronic Pain/*therapy; Drugs, Chinese Herbal/therapeutic use; Humans; Inositol/therapeutic use; Middle Aged; Neuralgia/*therapy; Nimodipine/therapeutic use; Pain Measurement; Quality of Life; Randomized Controlled Trials as Topic; Vitamin B 12/analogs & derivatives/therapeutic use  
  Abstract BACKGROUND: Neuropathic pain may be caused by nerve damage, and is often followed by changes to the central nervous system. Uncertainty remains regarding the effectiveness and safety of acupuncture treatments for neuropathic pain, despite a number of clinical trials being undertaken. OBJECTIVES: To assess the analgesic efficacy and adverse events of acupuncture treatments for chronic neuropathic pain in adults. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, four Chinese databases, ClinicalTrials.gov and World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) on 14 February 2017. We also cross checked the reference lists of included studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) with treatment duration of eight weeks or longer comparing acupuncture (either given alone or in combination with other therapies) with sham acupuncture, other active therapies, or treatment as usual, for neuropathic pain in adults. We searched for studies of acupuncture based on needle insertion and stimulation of somatic tissues for therapeutic purposes, and we excluded other methods of stimulating acupuncture points without needle insertion. We searched for studies of manual acupuncture, electroacupuncture or other acupuncture techniques used in clinical practice (such as warm needling, fire needling, etc). DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. The primary outcomes were pain intensity and pain relief. The secondary outcomes were any pain-related outcome indicating some improvement, withdrawals, participants experiencing any adverse event, serious adverse events and quality of life. For dichotomous outcomes, we calculated risk ratio (RR) with 95% confidence intervals (CI), and for continuous outcomes we calculated the mean difference (MD) with 95% CI. We also calculated number needed to treat for an additional beneficial outcome (NNTB) where possible. We combined all data using a random-effects model and assessed the quality of evidence using GRADE to generate 'Summary of findings' tables. MAIN RESULTS: We included six studies involving 462 participants with chronic peripheral neuropathic pain (442 completers (251 male), mean ages 52 to 63 years). The included studies recruited 403 participants from China and 59 from the UK. Most studies included a small sample size (fewer than 50 participants per treatment arm) and all studies were at high risk of bias for blinding of participants and personnel. Most studies had unclear risk of bias for sequence generation (four out of six studies), allocation concealment (five out of six) and selective reporting (all included studies). All studies investigated manual acupuncture, and we did not identify any study comparing acupuncture with treatment as usual, nor any study investigating other acupuncture techniques (such as electroacupuncture, warm needling, fire needling).One study compared acupuncture with sham acupuncture. We are uncertain if there is any difference between the two interventions on reducing pain intensity (n = 45; MD -0.4, 95% CI -1.83 to 1.03, very low-quality evidence), and neither group achieved 'no worse than mild pain' (visual analogue scale (VAS, 0-10) average score was 5.8 and 6.2 respectively in the acupuncture and sham acupuncture groups, where 0 = no pain). There was limited data on quality of life, which showed no clear difference between groups. Evidence was not available on pain relief, adverse events or other pre-defined secondary outcomes for this comparison.Three studies compared acupuncture alone versus other therapies (mecobalamin combined with nimodipine, and inositol). Acupuncture may reduce the risk of 'no clinical response' to pain than other therapies (n = 209; RR 0.25, 95% CI 0.12 to 0.51), however, evidence was not available for pain intensity, pain relief, adverse events or any of the other secondary outcomes.Two studies compared acupuncture combined with other active therapies (mecobalamin, and Xiaoke bitong capsule) versus other active therapies used alone. We found that the acupuncture combination group had a lower VAS score for pain intensity (n = 104; MD -1.02, 95% CI -1.09 to -0.95) and improved quality of life (n = 104; MD -2.19, 95% CI -2.39 to -1.99), than those receiving other therapy alone. However, the average VAS score of the acupuncture and control groups was 3.23 and 4.25 respectively, indicating neither group achieved 'no worse than mild pain'. Furthermore, this evidence was from a single study with high risk of bias and a very small sample size. There was no evidence on pain relief and we identified no clear differences between groups on other parameters, including 'no clinical response' to pain and withdrawals. There was no evidence on adverse events.The overall quality of evidence is very low due to study limitations (high risk of performance, detection, and attrition bias, and high risk of bias confounded by small study size) or imprecision. We have limited confidence in the effect estimate and the true effect is likely to be substantially different from the estimated effect. AUTHORS' CONCLUSIONS: Due to the limited data available, there is insufficient evidence to support or refute the use of acupuncture for neuropathic pain in general, or for any specific neuropathic pain condition when compared with sham acupuncture or other active therapies. Five studies are still ongoing and seven studies are awaiting classification due to the unclear treatment duration, and the results of these studies may influence the current findings.  
  Address College of Acumox and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29197180 Approved no  
  Call Number OCOM @ refbase @ Serial 2483  
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