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Author (up) 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 (up) 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 (up) 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 (up) 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 (up) 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 (up) 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 (up) 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 (up) 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 (up) 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 (up) 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 (up) Fang, S.; Wang, M.; Zheng, Y.; Zhou, S.; Ji, G. url  doi
openurl 
  Title Acupuncture and Lifestyle Modification Treatment for Obesity: A Meta-Analysis Type of Study Systematic Review
  Year 2017 Publication The American Journal of Chinese Medicine Abbreviated Journal Am J Chin Med  
  Volume 45 Issue 2 Pages 239-254  
  Keywords AcuTrials; Systematic Review; Nutritional and Metabolic Diseases; Obesity; Acupuncture; Body Mass Index  
  Abstract Obesity is an epidemic health hazard associated with many medical conditions. Lifestyle interventions are foundational to the successful management of obesity. However, the body's adaptive biological responses counteract patients' desire to restrict food and energy intake, leading to weight regain. As a complementary and alternative medical approach, acupuncture therapy is widely used for weight control. The objective of this study was to assess the efficacy of acupuncture treatment alone and in combination with lifestyle modification. We searched the MEDLINE, EMBASE, CENTRAL and Chinese Biomedical Literature Databases for relevant publications available as of 24 October 2015 without language restriction. Eligible studies consisted of randomized controlled trials for acupuncture with comparative controls. A total of 23 studies were included with 1808 individuals. We performed meta-analyses of weighted mean differences based on a random effect model. Acupuncture exhibited a mean difference of body mass index reduction of 1.742[Formula: see text]kg/m2 (95% confidence interval [Formula: see text]) and 1.904[Formula: see text]kg/m2 (95% confidence interval [Formula: see text]) when compared with untreated or placebo control groups and when lifestyle interventions including basic therapy of both treatment and control groups. Adverse events reported were mild, and no patients withdrew because of adverse effects. Overall, our results indicate that acupuncture is an effective treatment for obesity both alone and together with lifestyle modification.  
  Address Prof. Guang Ji, Institution of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Fenglin Street, Shanghai 200032, P. R. China  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition Obesity
  Disease Category Nutritional and Metabolic Diseases OCSI Score  
  Notes PMID:28231746 Approved yes  
  Call Number OCOM @ refbase @ Serial 2179  
Permanent link to this record
 

 
Author (up) Gattie, E.; Cleland, J.A.; Snodgrass, S. url  doi
openurl 
  Title The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis Type of Study Systematic Review
  Year 2017 Publication The Journal of Orthopaedic and Sports Physical Therapy Abbreviated Journal J Orthop Sports Phys Ther  
  Volume 47 Issue 3 Pages 133-149  
  Keywords AcuTrials; Systematic Review; Pain; Musculoskeletal Diseases; Dry Needling; Myofascial Trigger Points  
  Abstract Study Design Systematic review and meta-analysis. Background An increasing number of physical therapists in the United States and throughout the world are using dry needling to treat musculoskeletal pain. Objective To examine the short- and long-term effectiveness of dry needling delivered by a physical therapist for any musculoskeletal pain condition. Methods Electronic databases were searched. Eligible randomized controlled trials included those with human subjects who had musculoskeletal conditions that were treated with dry needling performed by a physical therapist, compared with a control or other intervention. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation. Results The initial search returned 218 articles. After screening, 13 were included. Physiotherapy Evidence Database quality scale scores ranged from 4 to 9 (out of a maximum score of 10), with a median score of 7. Eight meta-analyses were performed. In the immediate to 12-week follow-up period, studies provided evidence that dry needling may decrease pain and increase pressure pain threshold when compared to control/sham or other treatment. At 6 to 12 months, dry needling was favored for decreasing pain, but the treatment effect was not statistically significant. Dry needling, when compared to control/sham treatment, provides a statistically significant effect on functional outcomes, but not when compared to other treatments. Conclusion Very low-quality to moderate-quality evidence suggests that dry needling performed by physical therapists is more effective than no treatment, sham dry needling, and other treatments for reducing pain and improving pressure pain threshold in patients presenting with musculoskeletal pain in the immediate to 12-week follow-up period. Low-quality evidence suggests superior outcomes with dry needling for functional outcomes when compared to no treatment or sham needling. However, no difference in functional outcomes exists when compared to other physical therapy treatments. Evidence of long-term benefit of dry needling is currently lacking. Level of Evidence Therapy, level 1a. J Orthop Sports Phys Ther 2017;47(3):133-149. Epub 3 Feb 2017. doi:10.2519/jospt.2017.7096.  
  Address Dr Eric Gattie, 264 Pleasant Street, Concord, NH 03301  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition Pain
  Disease Category Pain OCSI Score  
  Notes PMID:28158962 Approved yes  
  Call Number OCOM @ refbase @ Serial 2212  
Permanent link to this record
 

 
Author (up) Grant, S.; Colaiaco, B.; Motala, A.; Shanman, R.; Sorbero, M.; Hempel, S. url  doi
openurl 
  Title Acupuncture for the Treatment of Adults with Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis Type of Study Journal Article
  Year 2017 Publication Journal of Trauma & Dissociation : the Official Journal of the International Society for the Study of Dissociation (ISSD) Abbreviated Journal J Trauma Dissociation  
  Volume Issue Pages 1-20  
  Keywords Alternative medicine; complementary medicine; meta-analysis; posttraumatic stress disorder; systematic review  
  Abstract Acupuncture has been suggested as a treatment for posttraumatic stress disorder (PTSD), yet its clinical effects are unclear. This review aims to estimate effects of acupuncture on PTSD symptoms, depressive symptoms, anxiety symptoms, and sleep quality for adults with PTSD. We searched 10 databases in January 2016 to identify eligible randomized controlled trials (RCTs). We performed random effects meta-analyses and examined quality of the body of evidence (QoE) using the GRADE approach to rate confidence in meta-analytic effect estimates. Seven RCTs with 709 participants met inclusion criteria. We identified very low QoE indicating significant differences favoring acupuncture (versus any comparator) at post-intervention on PTSD symptoms (standardized mean difference [SMD] = -0.80, 95% confidence interval [CI] [-1.59, -0.01], 6 RCTs), and low QoE at longer follow-up on PTSD (SMD = -0.46, 95% CI [-0.85, -0.06], 4 RCTs) and depressive symptoms (SMD = -0.56; 95% CI [-0.88, -0.23], 4 RCTs). No significant differences were observed between acupuncture and comparators at post-intervention for depressive symptoms (SMD = -0.58, 95% CI [-1.18, 0.01], 6 RCTs, very low QoE), anxiety symptoms (SMD = -0.82, 95% CI [-2.16, 0.53], 4 RCTs, very low QoE), and sleep quality (SMD = -0.46, 95% CI [-3.95, 3.03], 2 RCTs, low QoE). Safety data (7 RCTs) suggest little risk of serious adverse events, though some participants experienced minor/moderate pain, superficial bleeding, and hematoma at needle insertion sites. To increase confidence in findings, sufficiently powered replication trials are needed that measure all relevant clinical outcomes and dedicate study resources to minimizing participant attrition.  
  Address a RAND Corporation , Santa Monica , California , USA  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:28151093 Approved no  
  Call Number OCOM @ refbase @ Serial 2214  
Permanent link to this record
 

 
Author (up) Guo, T.; Chen, Z.; Tai, X.; Liu, Z.; Zhu, M. url  doi
openurl 
  Title Space-time acupuncture for intractable cough after lupus nephropathy: A case report and literature review Type of Study Journal Article
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 51 Pages e9309  
  Keywords *Acupuncture Therapy; Chronic Disease; Cough/*therapy; Fatigue/therapy; Female; Humans; Low Back Pain/therapy; Lupus Nephritis/*complications; Middle Aged  
  Abstract RATIONALE: Some intractable chronic cough remains a common complaint for seeking medical care. Unexplained cough in lupus nephropathy patient is rare and therapeutic options are limited. PATIENT CONCERNS: A 57 year-old woman with a 7-year history of lupus nephropathy. She has suffered from chronic cough for 3 years accompanied with chronic low back pain and fatigue, as the conventional therapy cannot relieve the symptoms. DIAGNOSES: The woman is diagnosed as intractable cough after lupus nephropathy. INTERVENTIONS: 9 times space-time acupuncture (STA) treatment was performed. OUTCOMES: The cough, as well as other uncomfortable symptoms like chronic low-back pain and fatigue have resolved, and no relapse for one year follow-up. LESSONS: STA may be an effective therapy to treat intractable chronic cough.  
  Address Curie Medical School,Universityof Paris, Paris, France  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29390501; PMCID:PMC5758203 Approved no  
  Call Number OCOM @ refbase @ Serial 2433  
Permanent link to this record
 

 
Author (up) Guo, T.; Chen, Z.; Tai, X.; Liu, Z.; Zhu, M. url  doi
openurl 
  Title Space-time acupuncture for intractable cough after lupus nephropathy: A case report and literature review Type of Study Journal Article
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 51 Pages e9309  
  Keywords *Acupuncture Therapy; Chronic Disease; Cough/*therapy; Fatigue/therapy; Female; Humans; Low Back Pain/therapy; Lupus Nephritis/*complications; Middle Aged  
  Abstract RATIONALE: Some intractable chronic cough remains a common complaint for seeking medical care. Unexplained cough in lupus nephropathy patient is rare and therapeutic options are limited. PATIENT CONCERNS: A 57 year-old woman with a 7-year history of lupus nephropathy. She has suffered from chronic cough for 3 years accompanied with chronic low back pain and fatigue, as the conventional therapy cannot relieve the symptoms. DIAGNOSES: The woman is diagnosed as intractable cough after lupus nephropathy. INTERVENTIONS: 9 times space-time acupuncture (STA) treatment was performed. OUTCOMES: The cough, as well as other uncomfortable symptoms like chronic low-back pain and fatigue have resolved, and no relapse for one year follow-up. LESSONS: STA may be an effective therapy to treat intractable chronic cough.  
  Address Curie Medical School,Universityof Paris, Paris, France  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29390501; PMCID:PMC5758203 Approved no  
  Call Number OCOM @ refbase @ Serial 2474  
Permanent link to this record
 

 
Author (up) Guo, T.; Chen, Z.; Tai, X.; Liu, Z.; Zhu, M. url  doi
openurl 
  Title Space-time acupuncture for intractable cough after lupus nephropathy: A case report and literature review Type of Study Journal Article
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 51 Pages e9309  
  Keywords *Acupuncture Therapy; Chronic Disease; Cough/*therapy; Fatigue/therapy; Female; Humans; Low Back Pain/therapy; Lupus Nephritis/*complications; Middle Aged  
  Abstract RATIONALE: Some intractable chronic cough remains a common complaint for seeking medical care. Unexplained cough in lupus nephropathy patient is rare and therapeutic options are limited. PATIENT CONCERNS: A 57 year-old woman with a 7-year history of lupus nephropathy. She has suffered from chronic cough for 3 years accompanied with chronic low back pain and fatigue, as the conventional therapy cannot relieve the symptoms. DIAGNOSES: The woman is diagnosed as intractable cough after lupus nephropathy. INTERVENTIONS: 9 times space-time acupuncture (STA) treatment was performed. OUTCOMES: The cough, as well as other uncomfortable symptoms like chronic low-back pain and fatigue have resolved, and no relapse for one year follow-up. LESSONS: STA may be an effective therapy to treat intractable chronic cough.  
  Address Curie Medical School,Universityof Paris, Paris, France  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29390501; PMCID:PMC5758203 Approved no  
  Call Number OCOM @ refbase @ Serial 2515  
Permanent link to this record
 

 
Author (up) Guo, T.; Chen, Z.; Tai, X.; Liu, Z.; Zhu, M. url  doi
openurl 
  Title Space-time acupuncture for intractable cough after lupus nephropathy: A case report and literature review Type of Study Journal Article
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 51 Pages e9309  
  Keywords *Acupuncture Therapy; Chronic Disease; Cough/*therapy; Fatigue/therapy; Female; Humans; Low Back Pain/therapy; Lupus Nephritis/*complications; Middle Aged  
  Abstract RATIONALE: Some intractable chronic cough remains a common complaint for seeking medical care. Unexplained cough in lupus nephropathy patient is rare and therapeutic options are limited. PATIENT CONCERNS: A 57 year-old woman with a 7-year history of lupus nephropathy. She has suffered from chronic cough for 3 years accompanied with chronic low back pain and fatigue, as the conventional therapy cannot relieve the symptoms. DIAGNOSES: The woman is diagnosed as intractable cough after lupus nephropathy. INTERVENTIONS: 9 times space-time acupuncture (STA) treatment was performed. OUTCOMES: The cough, as well as other uncomfortable symptoms like chronic low-back pain and fatigue have resolved, and no relapse for one year follow-up. LESSONS: STA may be an effective therapy to treat intractable chronic cough.  
  Address Curie Medical School,Universityof Paris, Paris, France  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29390501; PMCID:PMC5758203 Approved no  
  Call Number OCOM @ refbase @ Serial 2556  
Permanent link to this record
 

 
Author (up) Guo, T.; Chen, Z.; Tai, X.; Liu, Z.; Zhu, M. url  doi
openurl 
  Title Space-time acupuncture for intractable cough after lupus nephropathy: A case report and literature review Type of Study Journal Article
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 51 Pages e9309  
  Keywords *Acupuncture Therapy; Chronic Disease; Cough/*therapy; Fatigue/therapy; Female; Humans; Low Back Pain/therapy; Lupus Nephritis/*complications; Middle Aged  
  Abstract RATIONALE: Some intractable chronic cough remains a common complaint for seeking medical care. Unexplained cough in lupus nephropathy patient is rare and therapeutic options are limited. PATIENT CONCERNS: A 57 year-old woman with a 7-year history of lupus nephropathy. She has suffered from chronic cough for 3 years accompanied with chronic low back pain and fatigue, as the conventional therapy cannot relieve the symptoms. DIAGNOSES: The woman is diagnosed as intractable cough after lupus nephropathy. INTERVENTIONS: 9 times space-time acupuncture (STA) treatment was performed. OUTCOMES: The cough, as well as other uncomfortable symptoms like chronic low-back pain and fatigue have resolved, and no relapse for one year follow-up. LESSONS: STA may be an effective therapy to treat intractable chronic cough.  
  Address Curie Medical School,Universityof Paris, Paris, France  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29390501; PMCID:PMC5758203 Approved no  
  Call Number OCOM @ refbase @ Serial 2597  
Permanent link to this record
 

 
Author (up) Guo, T.; Chen, Z.; Tai, X.; Liu, Z.; Zhu, M. url  doi
openurl 
  Title Space-time acupuncture for intractable cough after lupus nephropathy: A case report and literature review Type of Study Journal Article
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 51 Pages e9309  
  Keywords *Acupuncture Therapy; Chronic Disease; Cough/*therapy; Fatigue/therapy; Female; Humans; Low Back Pain/therapy; Lupus Nephritis/*complications; Middle Aged  
  Abstract RATIONALE: Some intractable chronic cough remains a common complaint for seeking medical care. Unexplained cough in lupus nephropathy patient is rare and therapeutic options are limited. PATIENT CONCERNS: A 57 year-old woman with a 7-year history of lupus nephropathy. She has suffered from chronic cough for 3 years accompanied with chronic low back pain and fatigue, as the conventional therapy cannot relieve the symptoms. DIAGNOSES: The woman is diagnosed as intractable cough after lupus nephropathy. INTERVENTIONS: 9 times space-time acupuncture (STA) treatment was performed. OUTCOMES: The cough, as well as other uncomfortable symptoms like chronic low-back pain and fatigue have resolved, and no relapse for one year follow-up. LESSONS: STA may be an effective therapy to treat intractable chronic cough.  
  Address Curie Medical School,Universityof Paris, Paris, France  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29390501; PMCID:PMC5758203 Approved no  
  Call Number OCOM @ refbase @ Serial 2657  
Permanent link to this record
 

 
Author (up) Guo, T.; Chen, Z.; Tai, X.; Liu, Z.; Zhu, M. url  doi
openurl 
  Title Space-time acupuncture for intractable cough after lupus nephropathy: A case report and literature review Type of Study Journal Article
  Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)  
  Volume 96 Issue 51 Pages e9309  
  Keywords *Acupuncture Therapy; Chronic Disease; Cough/*therapy; Fatigue/therapy; Female; Humans; Low Back Pain/therapy; Lupus Nephritis/*complications; Middle Aged  
  Abstract RATIONALE: Some intractable chronic cough remains a common complaint for seeking medical care. Unexplained cough in lupus nephropathy patient is rare and therapeutic options are limited. PATIENT CONCERNS: A 57 year-old woman with a 7-year history of lupus nephropathy. She has suffered from chronic cough for 3 years accompanied with chronic low back pain and fatigue, as the conventional therapy cannot relieve the symptoms. DIAGNOSES: The woman is diagnosed as intractable cough after lupus nephropathy. INTERVENTIONS: 9 times space-time acupuncture (STA) treatment was performed. OUTCOMES: The cough, as well as other uncomfortable symptoms like chronic low-back pain and fatigue have resolved, and no relapse for one year follow-up. LESSONS: STA may be an effective therapy to treat intractable chronic cough.  
  Address Curie Medical School,Universityof Paris, Paris, France  
  Publisher
  Language English Number of Treatments  
  Treatment Follow-up Frequency Number of Participants  
  Time in Treatment Condition
  Disease Category OCSI Score  
  Notes PMID:29390501; PMCID:PMC5758203 Approved no  
  Call Number OCOM @ refbase @ Serial 2698  
Permanent link to this record
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