Evidence map›Paper›PMID 39639534›Full record

Trial reportClinical rehabilitation2025

Cost consequences analysis of early vocational rehabilitation compared with usual care for stroke survivors.

Sarah Pyne, Tracey H Sach, Rory Cameron, Helen Risebro, Alexandra Wright-Hughes, Ellen Thompson, Dame Caroline Watkins, Audrey Bowen, Judith Stevens, Amanda J Farrin and 6 more

Abstract readComparative StudyMulticenter StudyPragmatic Clinical Trial
In one paragraph

Trial report in Clinical rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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

What it found

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

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

2 · The registry

The trial behind it

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

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

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
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

16 authors.

Sarah PyneHealth Economics Group, University of East Anglia, Norwich, UK.ORCID 0000-0003-0093-9125
Tracey H SachHealth Economics Group, University of East Anglia, Norwich, UK.ORCID 0000-0002-8098-9220
Rory CameronHealth Economics Group, University of East Anglia, Norwich, UK.
Helen RisebroHealth Economics Group, University of East Anglia, Norwich, UK.
Alexandra Wright-HughesLeeds Institute for Clinical Trials Research, University of Leeds, Leeds, UK.
Ellen ThompsonLeeds Institute for Clinical Trials Research, University of Leeds, Leeds, UK.
Dame Caroline WatkinsApplied Health Research Hub and School of Nursing and Midwifery, University of Central Lancashire, Preston, UK.
Audrey BowenManchester Centre for Health Psychology, and Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK.ORCID 0000-0003-4075-1215
Judith StevensPPI, UK.
Amanda J FarrinLeeds Institute for Clinical Trials Research, University of Leeds, Leeds, UK.
Christopher McKevittDivision of Health and Social Care Research, King's College London, London, UK.
John D MurrayPPI, UK.
Rory J O'ConnorAcademic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK.
Julie PhillipsCentre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK.
Kate A RadfordCentre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-6246-3180
RETAKE research group *

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare costs and consequences of Early Stroke Specialist Vocational Rehabilitation (ESSVR) with usual care in working age, stroke survivors over 12 months.

designAn economic evaluation nested within the pragmatic, multi-centre, randomised, controlled RETurn to work After stroKE (RETAKE) study.

settingTwenty-one English and Welsh National Health Service (NHS) hospital-based stroke units. A UK NHS and Personal Social Services perspective was taken in the base-case and a wider perspective (participant, family, employer and other public services) in a secondary analysis.

participantsA total of 583 stroke survivors age ≥18 years (mean 54.0 years, 69% male).

interventionsParticipants were randomised to ESSVR, an early, individually tailored (in content, dose, intensity and duration) intervention, plus usual care or usual care alone. MAIN MEASURES: Disease-specific resource-use data and EQ-5D-5L (health-related quality of life) collected at baseline, 3, 6 and 12 months. Resource-use items were valued using unit costs in UK£ 2021/22. EQ-5D-5L was used to estimate Quality-adjusted life-years (QALYs). If ESSVR was found effective, an incremental cost-utility analysis was planned, otherwise a cost-consequence analysis.

resultsThe clinical study found no evidence of a between-group difference in the proportion of participants returning to work at 12 months. This, and the level of missing data, means a cost-consequence analysis is reported. Using imputed data, ESSVR plus usual care is estimated to be more expensive with slightly higher QALYs compared with usual care.

conclusionsEarly Stroke Specialist Vocational Rehabilitation is unlikely to be considered cost-effective over 12 months, which fits with the clinical finding of no between-group difference in return-to-work rates post-stroke. CLINICAL TRIAL REGISTRATION INFORMATION: The ISRCTN registry: ISRCTN12464275 https://doi.org/10.1186/ISRCTN12464275.

Indexed as

Rehabilitation, VocationalReturn to WorkStrokeStroke RehabilitationAdultAgedCost-Benefit AnalysisFemaleHumansMaleMiddle AgedQuality-Adjusted Life YearsQuality of LifeSurvivorsUnited Kingdomcost consequenceeconomic evaluationrehabilitationreturn to workStroke

Identifiers

PMID39639534
PMCPMC11846267

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.