Abstract:
BACKGROUND:Stroke survivors encounter emotional problems in the chronic phase after stroke. Post-stroke depressive symptoms have major impact on health-related quality of life (HRQol) and lead to increased hospitalization and therefore substantial healthcare costs. We present a cost-effectiveness and cost-utility evaluation of a cognitive behavioural therapy augmented with occupational and movement therapy to support patients with a stroke with depressive symptoms in goal-setting and goal attainment (augmented CBT) in comparison with a computerized cognitive training program (CogniPlus) as a control intervention. METHODS:A trial-based economic evaluation was conducted from a societal perspective with a time horizon of 12 months. Stroke patients (aged 18+ years) with signs of depression (Hospital Anxiety and Depression Scale (HADS) - subscale depression > 7) were eligible to participate. Primary outcomes were the HADS and Quality Adjusted Life Years (QALYs) based on the three-level five-dimensional EuroQol (EQ-5D-3 L). Missing data were handled through mean imputation (costs) and multiple imputation (HADS and EuroQol), and costs were bootstrapped. Sensitivity analyses were performed to test robustness of baseline assumptions. RESULTS:Sixty-one patients were included. The average total societal costs were not significantly different between the control group (€9,998.3) and the augmented CBT group (€8,063.7), with a 95 % confidence interval (-5,284, 1,796). The augmented CBT intervention was less costly and less effective from a societal perspective on the HADS, and less costly and slightly more effective in QALYs, in comparison with the control treatment. The cost-effectiveness and cost-utility analyses provided greater effects and fewer costs for the augmented CBT group, and fewer effects and costs for the HADS. Based on a willingness to pay (WTP) level of €40,000 per QALY, the augmented CBT intervention had a 76 % chance of being cost-effective. Sensitivity analyses showed robustness of results. CONCLUSION:The stroke-specific augmented CBT intervention did not show convincing cost-effectiveness results. In addition to other literature, this study provided new insights into the potential cost-effectiveness of an adjusted cognitive behavioural therapy intervention. However, as our study showed a 76 % chance of being cost-effective for one outcome measure (QALY) and did not provide convincing cost-effectiveness results on the HADS we recommend further research in a larger population.
journal_name
BMC Neuroljournal_title
BMC neurologyauthors
van Eeden M,Kootker JA,Evers SM,van Heugten CM,Geurts AC,van Mastrigt GAdoi
10.1186/s12883-015-0522-ysubject
Has Abstractpub_date
2015-12-29 00:00:00pages
266issn
1471-2377pii
10.1186/s12883-015-0522-yjournal_volume
15pub_type
杂志文章,多中心研究,随机对照试验相关文献
BMC Neurology文献大全abstract:BACKGROUND:The Stroke burden is increasing in many populations where health institutions may experience more patients. We wanted to examine whether incidence rates and absolute number of hospitalized stroke patients remained stable in Denmark during a 13 years period where exposure to major stroke risk factors decrease...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/1471-2377-13-156
更新日期:2013-10-30 00:00:00
abstract:BACKGROUND:Rett syndrome is a severe neurodevelopmental disorder that primarily affects females. Typical features include a loss of purposeful hand skills, development of hand stereotypies, loss of spoken language, gait abnormalities, and acquired microcephaly. However, Rett syndrome hasn't been recognized by clinical ...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-016-0613-4
更新日期:2016-06-13 00:00:00
abstract:BACKGROUND:Neurogenic orthostatic hypotension (nOH) results from impaired vasoconstriction due to dysfunction of the autonomic nervous system and is commonly associated with Parkinson disease (PD), multiple system atrophy (MSA), and pure autonomic failure. nOH can increase the risk of falls due to symptoms that include...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-018-1129-x
更新日期:2018-08-25 00:00:00
abstract:BACKGROUND:Common carotid artery occlusive disease (CCAOD) could form internal carotid artery steal pathways. Based on the diagnostic results of digital subtraction angiography (DSA), head and neck computed tomography angiography (CTA) was used to find the internal carotid artery stealing pathway after CCAOD. METHODS:...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-020-01915-w
更新日期:2020-09-03 00:00:00
abstract:BACKGROUND:Spinal cord infarction (SCI) is rarely caused by vertebral artery dissection (VAD), which is an important cause of posterior circulation stroke in young and middle-aged patients. We report the case of a middle-aged patient without obvious risk factors for atherosclerosis who had SCI from right VAD. CASE PRE...
journal_title:BMC neurology
pub_type: 杂志文章,评审
doi:10.1186/s12883-019-1559-0
更新日期:2019-12-12 00:00:00
abstract:BACKGROUND:Tumor location served as an important prognostic factor in glioma patients was considered to postulate molecular features according to cell origin theory. However, anatomic distribution of unique molecular subtypes was not widely investigated. The relationship between molecular phenotype and histological sub...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-017-0961-8
更新日期:2017-09-15 00:00:00
abstract:BACKGROUND:Infectious basilar artery (BA) aneurysm has been occasionally reported to be generated from meningitis following transcranial operation. However, infectious BA aneurysm formed by intracranial infection after endoscopic endonasal operation has never been reported. CASE PRESENTATION:A 53-year-old man who was ...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-020-01673-9
更新日期:2020-03-14 00:00:00
abstract:BACKGROUND:Ramsay Hunt syndrome (RHS) is caused by a reactivation of varicella-zoster virus (VZV) infection, and it is characterized by the symptoms of facial paralysis, otalgia, auricular rash, and/or an oral lesion. Elderly patients or immunocompromised patients, deep pain at the initial visit and no prompt treatment...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-021-02071-5
更新日期:2021-01-28 00:00:00
abstract:BACKGROUND:Cognitive impairment commonly occurs in the acute phase post-stroke, but may persist with over half of all stroke survivors experiencing some form of long-term cognitive deficit. Recent evidence suggests that optimising secondary prevention adherence is a critical factor in preventing recurrent stroke and th...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-015-0288-2
更新日期:2015-03-12 00:00:00
abstract:BACKGROUND:To evaluate the relationship between the flow signal intensity of branch arteries distal to the stenosis on 3-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) and the risk of stroke recurrence in patients with severe middle cerebral artery (MCA) trunk stenosis. METHODS:We prospecti...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-015-0423-0
更新日期:2015-09-16 00:00:00
abstract:BACKGROUND:Patients often report neurocognitive difficulties after neuroborreliosis (NB). The frequency and extent of cognitive problems in European patients have been studied incompletely. METHODS:Sixty patients received a neurological and neuropsychological work-up 6 months or longer after treatment for proven NB. Q...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-015-0386-1
更新日期:2015-08-19 00:00:00
abstract:BACKGROUND:Young ischemic stroke patients are common while classification and analysis based upon imaging characteristics are rarely reported. We intend to compare the clinical and MRI characteristics of cerebral stroke induced by intracranial atherosclerosis between young patients with branch occlusive disease (BOD) a...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-018-1089-1
更新日期:2018-06-20 00:00:00
abstract:BACKGROUND:Lumbo-sacral radiculopathy (LSR) is a common musculoskeletal disorder for which patients seek medical care and referrals for advanced imaging. However, accurate diagnosis remains challenging. Neuropathic pain screening questionnaires, clinical neurological examination and magnetic resonance imaging (MRI) are...
journal_title:BMC neurology
pub_type: 杂志文章,多中心研究
doi:10.1186/s12883-019-1333-3
更新日期:2019-05-30 00:00:00
abstract:BACKGROUND:Clinical reasoning in Neurology is based on general associations which help to deduce the site of the lesion. However, even "golden principles" may occasionally be deceptive. Here, we describe the case of subacute flaccid tetraparesis due to motor cortical lesions. To our knowledge, this is the first report ...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-017-0814-5
更新日期:2017-02-10 00:00:00
abstract:BACKGROUND:Primary familial brain calcification is a rare autosomal dominant or recessive neurodegenerative disease, characterized by bilateral brain calcifications in different areas of the brain. It is a clinically heterogeneous disease and patients are reported to exhibit a wide spectrum of neurological and psychiat...
journal_title:BMC neurology
pub_type: 杂志文章,评审
doi:10.1186/s12883-019-1292-8
更新日期:2019-04-12 00:00:00
abstract:BACKGROUND:The time from injury to surgery (TIS) is critical in the functional recovery of individuals with traumatic acute subdural hematoma (TASDH). However, only few studies have confirmed such notion. METHODS:The data of TASDH patients who were surgically treated in Chia-Yi Christian Hospital between January 2008 ...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-020-01810-4
更新日期:2020-06-04 00:00:00
abstract:BACKGROUND:The available health resources limit the amount of therapy that may be offered to children with cerebral palsy and the amount of training in each session may be insufficient to drive the neuroplastic changes, which are necessary for functional improvements to take place. The aim of this pilot study was to pr...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/1471-2377-11-32
更新日期:2011-03-09 00:00:00
abstract:BACKGROUND:"Anarchic hand" is a rare condition characterised by non-volitional, goal-directed movements of one arm. We report a case with analysis of structural and functional connectivity. CASE PRESENTATION:A 15 year old girl developed intermittent symptoms of intermanual conflict or anarchic hand as a result of trau...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-015-0477-z
更新日期:2015-11-14 00:00:00
abstract:BACKGROUND:Myasthenia gravis (MG), an autoimmune neuromuscular disorder, occurs owing to autoantibodies against acetylcholine receptors. MG symptoms can be triggered by various vaccines. Many studies have evaluated the safety and adverse events of the human papillomavirus (HPV) vaccine. Here, we present a life-threaten...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-018-1233-y
更新日期:2018-12-28 00:00:00
abstract:BACKGROUND:Despite substantial research into the topic and valiant surgical efforts, reconstruction of peripheral nerve injury remains a challenging surgery. This study was conducted to evaluate the effectiveness of axonal regeneration of a transected sciatic nerve through a vein conduit containing degenerated skeletal...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-016-0768-z
更新日期:2016-11-22 00:00:00
abstract:BACKGROUND:The clinical impact of neutralizing antibodies against interferon-beta (NAb) is controversial. Their presence can lead to a decrease in interferon-beta (IFNβ) efficacy. Fatigue reported in patients with multiple sclerosis (MS) may be associated with an unfavorable clinical course. We conducted a prospective ...
journal_title:BMC neurology
pub_type: 杂志文章,多中心研究
doi:10.1186/s12883-014-0215-y
更新日期:2014-11-30 00:00:00
abstract:BACKGROUND:Balanced Steady State Free Precession (b-SSFP) sequences and the newly developed Fast-Spin-Echo (FSE)-sequences enable an optimized visualization of neurovascular compression (NVC) in patients with trigeminal neuralgia (TN). Arterial conflicts are mostly associated with a favorable outcome of microvascular d...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-020-01860-8
更新日期:2020-07-14 00:00:00
abstract:BACKGROUND:Myasthenic crisis is the most serious life-threatening event in generalized myasthenia gravis (MG) patients. The objective of this study was to assess the long-term impact of thymectomy on rate and severity of these attacks in Iranian patients. METHODS:We reviewed the clinical records from 272 myasthenic pa...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/1471-2377-4-12
更新日期:2004-09-11 00:00:00
abstract:BACKGROUND:The disease burden of human immunodeficiency virus (HIV)--acquired immunodeficiency syndrome (AIDS) is highest in sub-Saharan Africa but there are few studies on the associated neurocognitive disorders in this region. The objectives of this study were to determine whether Western neuropsychological (NP) meth...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/1471-2377-10-60
更新日期:2010-07-13 00:00:00
abstract:BACKGROUND:Embolectomy is the standard of care in acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). Aim of this study was to compare two techniques: A Direct Aspiration First Pass Technique (ADAPT) and Stent-retriever Assisted Vacuum-locked Extraction (SAVE) stratified by the occluded vessel. METHODS...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-019-1291-9
更新日期:2019-04-15 00:00:00
abstract:BACKGROUND:Chest pain as the primary manifestation of epilepsy is extremely rare and has only been reported once to date. CASE PRESENTATION:We herein describe a 47-year-old woman with recurrent chest pain for 3 years. The cause of her chest pain remained elusive despite extensive investigations including comprehensive...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-019-1575-0
更新日期:2019-12-30 00:00:00
abstract:BACKGROUND:Cerebral amyloid angiopathy (CAA) refers to the deposition of β-amyloid (Aβ) peptides in the wall of brain vasculature, commonly involving capillaries and arterioles. Also being considered a part of CAA is the Aβ deposition in leptomeninge. The cellular origin of angiopathic Aβ and the pathogenic course of C...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-015-0327-z
更新日期:2015-05-02 00:00:00
abstract:BACKGROUND:Recent studies suggest that epigenetic factors may play an important role in the pathogenesis of Parkinson's disease (PD). In our previous work, we sequenced the exomes of sixteen patients from eight Chinese PD families using whole exome sequencing technology, consequently three patients from different pedig...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/1471-2377-13-196
更新日期:2013-12-11 00:00:00
abstract:BACKGROUND:The cognitive consequences of carbon monoxide (CO) poisoning are well described. However, most studies have been carried out without an ad-hoc group of control subjects. The main aim of this study was to evaluate cognitive and psychiatric outcome after CO exposure during the storm Klaus in the South West of ...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/1471-2377-14-153
更新日期:2014-07-21 00:00:00
abstract:BACKGROUND:Intravenous thrombolysis has been recently introduced in Nepal for the management of acute ischemic stroke. Pre-hospital delay is one of the main reasons that hinder thrombolytic therapy. The objective of this study was to evaluate the status of prehospital delay and thrombolysis in Nepal. METHODS:Data were...
journal_title:BMC neurology
pub_type: 杂志文章
doi:10.1186/s12883-019-1378-3
更新日期:2019-07-09 00:00:00