Evidence map›Paper›PMID 30337309›Full record

Trial reportBMJ open2018

Short-term and long-term cost-effectiveness of a pedometer-based exercise intervention in primary care: a within-trial analysis and beyond-trial modelling.

Nana Anokye, Julia Fox-Rushby, Sabina Sanghera, Derek G Cook, Elizabeth Limb, Cheryl Furness, Sally Margaret Kerry, Christina R Victor, Steve Iliffe, Michael Ussher and 4 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Nana AnokyeHealth Economics Research Group, Brunel University, London, UK.
Julia Fox-RushbyDepartment of Population Health Sciences, Guy's Campus, King's College London, London, UK.
Sabina SangheraSchool of Social and Community Medicine, University of Bristol, Bristol, UK.
Derek G CookPopulation Health Research Institute, St George's University of London, London, UK.
Elizabeth LimbPopulation Health Research Institute, St George's University of London, London, UK.
Cheryl FurnessPopulation Health Research Institute, St George's University of London, London, UK.
Sally Margaret KerryPragmatic Clinical Trials Unit, Queen Mary's University of London, London, UK.
Christina R VictorDepartment of Clinical Sciences, Brunel University London, Uxbridge, UK.
Steve IliffePopulation Health Research Institute, St George's University of London, London, UK.
Michael UssherPopulation Health Research Institute, St George's University of London, London, UK.
Peter H WhincupPopulation Health Research Institute, St George's University of London, London, UK.
Ulf EkelundDepartment of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
Stephen deWildePopulation Health Research Institute, St George's University of London, London, UK.
Tess HarrisPopulation Health Research Institute, St George's University of London, London, UK.

Funding

Department of Health 10/32/02
6 · The paper itself

Abstract

objectivesA short-term and long-term cost-effectiveness analysis (CEA) of two pedometer-based walking interventions compared with usual care.

design(A) Short-term CEA: parallel three-arm cluster randomised trial randomised by household. (B) Long-term CEA: Markov decision model.

settingSeven primary care practices in South London, UK.

participants(A) Short-term CEA: 1023 people (922 households) aged 45-75 years without physical activity (PA) contraindications. (b) Long-term CEA: a cohort of 100 000 people aged 59-88 years.

interventionsPedometers, 12-week walking programmes and PA diaries delivered by post or through three PA consultations with practice nurses. PRIMARY AND SECONDARY OUTCOME MEASURES: Accelerometer-measured change (baseline to 12 months) in average daily step count and time in 10 min bouts of moderate to vigorous PA (MVPA), and EQ-5D-5L quality-adjusted life-years (QALY).

methodsResource use costs (£2013/2014) from a National Health Service perspective, presented as incremental cost-effectiveness ratios for each outcome over a 1-year and lifetime horizon, with cost-effectiveness acceptability curves and willingness to pay per QALY. Deterministic and probabilistic sensitivity analyses evaluate uncertainty.

results(A) Short-term CEA: At 12 months, incremental cost was £3.61 (£109)/min in ≥10 min MVPA bouts for nurse support compared with control (postal group). At £20 000/QALY, the postal group had a 50% chance of being cost saving compared with control. (B) Long-term CEA: The postal group had more QALYs (+759 QALYs, 95% CI 400 to 1247) and lower costs (-£11 million, 95% CI -12 to -10) than control and nurse groups, resulting in an incremental net monetary benefit of £26 million per 100 000 population. Results were sensitive to reporting serious adverse events, excluding health service use, and including all participant costs.

conclusionsPostal delivery of a pedometer intervention in primary care is cost-effective long term and has a 50% chance of being cost-effective, through resource savings, within 1 year. Further research should ascertain maintenance of the higher levels of PA, and its impact on quality of life and health service use. TRIAL REGISTRATION NUMBER: ISRCTN98538934; Pre-results.

Indexed as

Postal ServiceWalkingActigraphyAgedAged, 80 and overAge FactorsCost-Benefit AnalysisFemaleFitness TrackersHealth PromotionHumansLondonMaleMarkov ChainsMental HealthMiddle Agedcost-effectivenesslong-term modellingphysical activityRCT

Identifiers

PMID30337309
PMCPMC6196874

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.