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Cost-Effectiveness Analysis Comparing Pre-diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario’s Autism Intervention Program / Melanie PENNER in Journal of Autism and Developmental Disorders, 45-9 (September 2015)
[article]
Titre : Cost-Effectiveness Analysis Comparing Pre-diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario’s Autism Intervention Program Type de document : Texte imprimé et/ou numérique Auteurs : Melanie PENNER, Auteur ; Meera RAYAR, Auteur ; Naazish BASHIR, Auteur ; S. Wendy ROBERTS, Auteur ; Rebecca L. HANCOCK-HOWARD, Auteur ; Peter C. COYTE, Auteur Article en page(s) : p.2833-2847 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder Cost-effectiveness Behavior therapy Independent living Economics Index. décimale : PER Périodiques Résumé : Novel management strategies for autism spectrum disorder (ASD) propose providing interventions before diagnosis. We performed a cost-effectiveness analysis comparing the costs and dependency-free life years (DFLYs) generated by pre-diagnosis intensive Early Start Denver Model (ESDM-I); pre-diagnosis parent-delivered ESDM (ESDM-PD); and the Ontario Status Quo (SQ). The analyses took government and societal perspectives to age 65. We assigned probabilities of Independent, Semi-dependent or Dependent living based on projected IQ. Costs per person (in Canadian dollars) were ascribed to each living setting. From a government perspective, the ESDM-PD produced an additional 0.17 DFLYs for $8600 less than SQ. From a societal perspective, the ESDM-I produced an additional 0.53 DFLYs for $45,000 less than SQ. Pre-diagnosis interventions targeting ASD symptoms warrant further investigation. En ligne : http://dx.doi.org/10.1007/s10803-015-2447-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267
in Journal of Autism and Developmental Disorders > 45-9 (September 2015) . - p.2833-2847[article] Cost-Effectiveness Analysis Comparing Pre-diagnosis Autism Spectrum Disorder (ASD)-Targeted Intervention with Ontario’s Autism Intervention Program [Texte imprimé et/ou numérique] / Melanie PENNER, Auteur ; Meera RAYAR, Auteur ; Naazish BASHIR, Auteur ; S. Wendy ROBERTS, Auteur ; Rebecca L. HANCOCK-HOWARD, Auteur ; Peter C. COYTE, Auteur . - p.2833-2847.
Langues : Anglais (eng)
in Journal of Autism and Developmental Disorders > 45-9 (September 2015) . - p.2833-2847
Mots-clés : Autism spectrum disorder Cost-effectiveness Behavior therapy Independent living Economics Index. décimale : PER Périodiques Résumé : Novel management strategies for autism spectrum disorder (ASD) propose providing interventions before diagnosis. We performed a cost-effectiveness analysis comparing the costs and dependency-free life years (DFLYs) generated by pre-diagnosis intensive Early Start Denver Model (ESDM-I); pre-diagnosis parent-delivered ESDM (ESDM-PD); and the Ontario Status Quo (SQ). The analyses took government and societal perspectives to age 65. We assigned probabilities of Independent, Semi-dependent or Dependent living based on projected IQ. Costs per person (in Canadian dollars) were ascribed to each living setting. From a government perspective, the ESDM-PD produced an additional 0.17 DFLYs for $8600 less than SQ. From a societal perspective, the ESDM-I produced an additional 0.53 DFLYs for $45,000 less than SQ. Pre-diagnosis interventions targeting ASD symptoms warrant further investigation. En ligne : http://dx.doi.org/10.1007/s10803-015-2447-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis / Rob ANDERSON in Journal of Child Psychology and Psychiatry, 55-12 (December 2014)
[article]
Titre : Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis Type de document : Texte imprimé et/ou numérique Auteurs : Rob ANDERSON, Auteur ; Obioha C. UKOUMUNNE, Auteur ; Kapil SAYAL, Auteur ; Rhiannon PHILLIPS, Auteur ; John A. TAYLOR, Auteur ; Melissa SPEARS, Auteur ; Ricardo ARAYA, Auteur ; Glyn LEWIS, Auteur ; Abigail MILLINGS, Auteur ; Alan A. MONTGOMERY, Auteur ; Paul STALLARD, Auteur Article en page(s) : p.1390-1397 Langues : Anglais (eng) Mots-clés : Depression prevention schools CBT cognitive behavioural therapy cost-effectiveness adolescents Index. décimale : PER Périodiques Résumé : Background A substantial minority of adolescents suffer from depression and it is associated with increased risk of suicide, social and educational impairment, and mental health problems in adulthood. A recently conducted randomized controlled trial in England evaluated the effectiveness of a manualized universally delivered age-appropriate CBT programme in school classrooms. The cost-effectiveness of the programme for preventing low mood and depression for all participants from a health and social care sector perspective needs to be determined. Methods A trial-based cost-effectiveness analysis based on a cluster-randomized controlled trial (trial registration – ISRCTN 19083628) comparing classroom-based CBT with usual school provision of Personal Social and Health Education. Per-student cost of intervention was estimated from programme records. The study was undertaken in eight mixed-sex UK secondary schools, and included 3,357 school children aged 12 to 16 years (in the two trial arms evaluated in the cost-effectiveness analysis). The main outcome measures were individual self-reported data on care costs, Quality-Adjusted Life-Years (QALYs, based on the EQ-5D health-related quality-of-life instrument) and symptoms of depression (Short Mood and Feelings Questionnaire) at baseline, 6 and 12 months. Results Although there was lower quality-adjusted life-years over 12 months (?.05 QALYs per person, 95% confidence interval ?.09 to ?.005, p = .03) with CBT, this is a ‘clinically’ negligible difference, which was not found in the complete case analyses. There was little evidence of any between-arm differences in SMFQ scores (0.19, 95% CI ?0.57 to 0.95, p = .62), or costs (£142, 95% CI ?£132 to £415, p = .31) per person for CBT versus usual school provision. Conclusions Our analysis suggests that the universal provision of classroom-based CBT is unlikely to be either more effective or less costly than usual school provision. En ligne : http://dx.doi.org/10.1111/jcpp.12248 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=243
in Journal of Child Psychology and Psychiatry > 55-12 (December 2014) . - p.1390-1397[article] Cost-effectiveness of classroom-based cognitive behaviour therapy in reducing symptoms of depression in adolescents: a trial-based analysis [Texte imprimé et/ou numérique] / Rob ANDERSON, Auteur ; Obioha C. UKOUMUNNE, Auteur ; Kapil SAYAL, Auteur ; Rhiannon PHILLIPS, Auteur ; John A. TAYLOR, Auteur ; Melissa SPEARS, Auteur ; Ricardo ARAYA, Auteur ; Glyn LEWIS, Auteur ; Abigail MILLINGS, Auteur ; Alan A. MONTGOMERY, Auteur ; Paul STALLARD, Auteur . - p.1390-1397.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 55-12 (December 2014) . - p.1390-1397
Mots-clés : Depression prevention schools CBT cognitive behavioural therapy cost-effectiveness adolescents Index. décimale : PER Périodiques Résumé : Background A substantial minority of adolescents suffer from depression and it is associated with increased risk of suicide, social and educational impairment, and mental health problems in adulthood. A recently conducted randomized controlled trial in England evaluated the effectiveness of a manualized universally delivered age-appropriate CBT programme in school classrooms. The cost-effectiveness of the programme for preventing low mood and depression for all participants from a health and social care sector perspective needs to be determined. Methods A trial-based cost-effectiveness analysis based on a cluster-randomized controlled trial (trial registration – ISRCTN 19083628) comparing classroom-based CBT with usual school provision of Personal Social and Health Education. Per-student cost of intervention was estimated from programme records. The study was undertaken in eight mixed-sex UK secondary schools, and included 3,357 school children aged 12 to 16 years (in the two trial arms evaluated in the cost-effectiveness analysis). The main outcome measures were individual self-reported data on care costs, Quality-Adjusted Life-Years (QALYs, based on the EQ-5D health-related quality-of-life instrument) and symptoms of depression (Short Mood and Feelings Questionnaire) at baseline, 6 and 12 months. Results Although there was lower quality-adjusted life-years over 12 months (?.05 QALYs per person, 95% confidence interval ?.09 to ?.005, p = .03) with CBT, this is a ‘clinically’ negligible difference, which was not found in the complete case analyses. There was little evidence of any between-arm differences in SMFQ scores (0.19, 95% CI ?0.57 to 0.95, p = .62), or costs (£142, 95% CI ?£132 to £415, p = .31) per person for CBT versus usual school provision. Conclusions Our analysis suggests that the universal provision of classroom-based CBT is unlikely to be either more effective or less costly than usual school provision. En ligne : http://dx.doi.org/10.1111/jcpp.12248 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=243 Cost-effectiveness of cognitive-behavioral therapy versus treatment as usual for anxiety disorders in children with autism spectrum disorder / Francisca J. A. VAN STEENSEL in Research in Autism Spectrum Disorders, 8-2 (February 2014)
[article]
Titre : Cost-effectiveness of cognitive-behavioral therapy versus treatment as usual for anxiety disorders in children with autism spectrum disorder Type de document : Texte imprimé et/ou numérique Auteurs : Francisca J. A. VAN STEENSEL, Auteur ; Carmen D. DIRKSEN, Auteur ; Susan M. BOGELS, Auteur Article en page(s) : p.127-137 Langues : Anglais (eng) Mots-clés : Anxiety CBT TAU Cost-effectiveness Index. décimale : PER Périodiques Résumé : Abstract The study's aim was to evaluate the cost-effectiveness of CBT compared to treatment as usual (TAU). In total, 49 children aged 8–18 years with ASD and comorbid anxiety disorders, and their parents, participated; 24 were assigned to CBT and 25 were assigned to TAU. Outcome measures were the percentage of children free from their primary anxiety disorder and quality adjusted life years (QALYs). Costs were measured using a retrospective cost-questionnaire. Effects and costs were assessed at pre-, post-, and three months after treatment. Effects and costs were not statistically different between CBT and TAU, however the incremental cost-effectiveness ratio (ICER) demonstrated that CBT dominates TAU. Bootstrapped ICERs demonstrated that CBT has a high probability to be more effective than TAU, however, the probability that either CBT or TAU is more costly did not differ much. Secondary analyses demonstrated fairly robust results. CBT seems a cost-effective intervention compared to TAU, however, long-term follow-ups and comparisons between CBT and specific TAUs are necessary. Cost-effectiveness analyses may help inform policy makers to decide how to treat anxiety disorders in children with ASD. En ligne : http://dx.doi.org/10.1016/j.rasd.2013.11.001 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=221
in Research in Autism Spectrum Disorders > 8-2 (February 2014) . - p.127-137[article] Cost-effectiveness of cognitive-behavioral therapy versus treatment as usual for anxiety disorders in children with autism spectrum disorder [Texte imprimé et/ou numérique] / Francisca J. A. VAN STEENSEL, Auteur ; Carmen D. DIRKSEN, Auteur ; Susan M. BOGELS, Auteur . - p.127-137.
Langues : Anglais (eng)
in Research in Autism Spectrum Disorders > 8-2 (February 2014) . - p.127-137
Mots-clés : Anxiety CBT TAU Cost-effectiveness Index. décimale : PER Périodiques Résumé : Abstract The study's aim was to evaluate the cost-effectiveness of CBT compared to treatment as usual (TAU). In total, 49 children aged 8–18 years with ASD and comorbid anxiety disorders, and their parents, participated; 24 were assigned to CBT and 25 were assigned to TAU. Outcome measures were the percentage of children free from their primary anxiety disorder and quality adjusted life years (QALYs). Costs were measured using a retrospective cost-questionnaire. Effects and costs were assessed at pre-, post-, and three months after treatment. Effects and costs were not statistically different between CBT and TAU, however the incremental cost-effectiveness ratio (ICER) demonstrated that CBT dominates TAU. Bootstrapped ICERs demonstrated that CBT has a high probability to be more effective than TAU, however, the probability that either CBT or TAU is more costly did not differ much. Secondary analyses demonstrated fairly robust results. CBT seems a cost-effective intervention compared to TAU, however, long-term follow-ups and comparisons between CBT and specific TAUs are necessary. Cost-effectiveness analyses may help inform policy makers to decide how to treat anxiety disorders in children with ASD. En ligne : http://dx.doi.org/10.1016/j.rasd.2013.11.001 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=221 The cost-effectiveness of supported employment for adults with autism in the United Kingdom / Ifigeneia MAVRANEZOULI in Autism, 18-8 (November 2014)
[article]
Titre : The cost-effectiveness of supported employment for adults with autism in the United Kingdom Type de document : Texte imprimé et/ou numérique Auteurs : Ifigeneia MAVRANEZOULI, Auteur ; Odette MEGNIN-VIGGARS, Auteur ; Nadir CHEEMA, Auteur ; Patricia HOWLIN, Auteur ; Simon BARON-COHEN, Auteur ; Stephen PILLING, Auteur Article en page(s) : p.975-984 Langues : Anglais (eng) Mots-clés : autism cost-effectiveness economics supported employment Index. décimale : PER Périodiques Résumé : Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom. Thus, a decision-analytic economic model was developed, which used outcome data from the only trial that has evaluated supported employment for adults with autism in the United Kingdom. The main analysis considered intervention costs, while cost-savings associated with changes in accommodation status and National Health Service and personal social service resource use were examined in secondary analyses. Two outcome measures were used: the number of weeks in employment and the quality-adjusted life year. Supported employment resulted in better outcomes compared with standard care, at an extra cost of £18 per additional week in employment or £5600 per quality-adjusted life year. In secondary analyses that incorporated potential cost-savings, supported employment dominated standard care (i.e. it produced better outcomes at a lower total cost). The analysis suggests that supported employment schemes for adults with autism in the United Kingdom are cost-effective compared with standard care. Further research needs to confirm these findings. En ligne : http://dx.doi.org/10.1177/1362361313505720 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=242
in Autism > 18-8 (November 2014) . - p.975-984[article] The cost-effectiveness of supported employment for adults with autism in the United Kingdom [Texte imprimé et/ou numérique] / Ifigeneia MAVRANEZOULI, Auteur ; Odette MEGNIN-VIGGARS, Auteur ; Nadir CHEEMA, Auteur ; Patricia HOWLIN, Auteur ; Simon BARON-COHEN, Auteur ; Stephen PILLING, Auteur . - p.975-984.
Langues : Anglais (eng)
in Autism > 18-8 (November 2014) . - p.975-984
Mots-clés : autism cost-effectiveness economics supported employment Index. décimale : PER Périodiques Résumé : Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom. Thus, a decision-analytic economic model was developed, which used outcome data from the only trial that has evaluated supported employment for adults with autism in the United Kingdom. The main analysis considered intervention costs, while cost-savings associated with changes in accommodation status and National Health Service and personal social service resource use were examined in secondary analyses. Two outcome measures were used: the number of weeks in employment and the quality-adjusted life year. Supported employment resulted in better outcomes compared with standard care, at an extra cost of £18 per additional week in employment or £5600 per quality-adjusted life year. In secondary analyses that incorporated potential cost-savings, supported employment dominated standard care (i.e. it produced better outcomes at a lower total cost). The analysis suggests that supported employment schemes for adults with autism in the United Kingdom are cost-effective compared with standard care. Further research needs to confirm these findings. En ligne : http://dx.doi.org/10.1177/1362361313505720 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=242