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Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model / J. SHEARER in Journal of Child Psychology and Psychiatry, 59-7 (July 2018)
[article]
Titre : Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model Type de document : Texte imprimé et/ou numérique Auteurs : J. SHEARER, Auteur ; N. PAPANIKOLAOU, Auteur ; R. MEISER-STEDMAN, Auteur ; A. MCKINNON, Auteur ; Tim DALGLEISH, Auteur ; P. SMITH, Auteur ; C. DIXON, Auteur ; Sarah BYFORD, Auteur Article en page(s) : p.773-780 Langues : Anglais (eng) Mots-clés : Economic evaluation cognitive therapy post-traumatic stress disorder Index. décimale : PER Périodiques Résumé : BACKGROUND: Untreated post-traumatic stress disorder (PTSD) in children and adolescents is associated with a considerable economic burden on the health system, families and society. Recent research has demonstrated the potential efficacy of cognitive therapy as an early intervention for PTSD in children and adolescents. Children who experienced a single traumatic event in the previous two to six months and were randomized to cognitive therapy for PTSD (CT-PTSD) were significantly more likely to be PTSD-free compared to those randomized to usual care represented by waitlist control. The current study evaluated the economic impact of improvements in the treatment of PTSD in children and adolescents. METHODS: A cost-effectiveness analysis was conducted from the national health service/personal social services perspective with outcomes expressed as quality-adjusted life years (QALYs). Patient level costs and outcomes were collected during the 11 week clinical trial and extrapolated to a three year time horizon using economic modelling methods. Uncertainty was estimated using probabilistic sensitivity analysis and assumptions were tested using one way sensitivity analysis. RESULTS: The incremental cost-effectiveness ratio at 3 years was pound2,205 per QALY with a 60%-69% probability of CT-PTSD being cost-effective compared to usual care at the UK pound20,000 to pound30,000 per QALY decision threshold. CONCLUSIONS: This study provides preliminary evidence for the cost-effectiveness of cognitive therapy in this treatment population. Larger pragmatic trials with longer follow-up are indicated. En ligne : http://dx.doi.org/10.1111/jcpp.12851 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=368
in Journal of Child Psychology and Psychiatry > 59-7 (July 2018) . - p.773-780[article] Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model [Texte imprimé et/ou numérique] / J. SHEARER, Auteur ; N. PAPANIKOLAOU, Auteur ; R. MEISER-STEDMAN, Auteur ; A. MCKINNON, Auteur ; Tim DALGLEISH, Auteur ; P. SMITH, Auteur ; C. DIXON, Auteur ; Sarah BYFORD, Auteur . - p.773-780.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 59-7 (July 2018) . - p.773-780
Mots-clés : Economic evaluation cognitive therapy post-traumatic stress disorder Index. décimale : PER Périodiques Résumé : BACKGROUND: Untreated post-traumatic stress disorder (PTSD) in children and adolescents is associated with a considerable economic burden on the health system, families and society. Recent research has demonstrated the potential efficacy of cognitive therapy as an early intervention for PTSD in children and adolescents. Children who experienced a single traumatic event in the previous two to six months and were randomized to cognitive therapy for PTSD (CT-PTSD) were significantly more likely to be PTSD-free compared to those randomized to usual care represented by waitlist control. The current study evaluated the economic impact of improvements in the treatment of PTSD in children and adolescents. METHODS: A cost-effectiveness analysis was conducted from the national health service/personal social services perspective with outcomes expressed as quality-adjusted life years (QALYs). Patient level costs and outcomes were collected during the 11 week clinical trial and extrapolated to a three year time horizon using economic modelling methods. Uncertainty was estimated using probabilistic sensitivity analysis and assumptions were tested using one way sensitivity analysis. RESULTS: The incremental cost-effectiveness ratio at 3 years was pound2,205 per QALY with a 60%-69% probability of CT-PTSD being cost-effective compared to usual care at the UK pound20,000 to pound30,000 per QALY decision threshold. CONCLUSIONS: This study provides preliminary evidence for the cost-effectiveness of cognitive therapy in this treatment population. Larger pragmatic trials with longer follow-up are indicated. En ligne : http://dx.doi.org/10.1111/jcpp.12851 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=368 Autism Research Funding Allocation: Can Economics Tell Us If We Have Got It Right? / Jennifer D. ZWICKER in Autism Research, 7-6 (December 2014)
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Titre : Autism Research Funding Allocation: Can Economics Tell Us If We Have Got It Right? Type de document : Texte imprimé et/ou numérique Auteurs : Jennifer D. ZWICKER, Auteur ; J. C. Herbert EMERY, Auteur Article en page(s) : p.704-711 Langues : Anglais (eng) Mots-clés : autism research funding economic evaluation funding allocation Index. décimale : PER Périodiques Résumé : There is a concern that the allocation of autism spectrum disorder (ASD) research funding may be misallocating resources, overemphasizing basic science at the expense of translational and clinical research. Anthony Bailey has proposed that an economic evaluation of autism research funding allocations could be beneficial for funding agencies by identifying under- or overfunded areas of research. In response to Bailey, we illustrate why economics cannot provide an objective, technical solution for identifying the “best” allocation of research resources. Economic evaluation has its greatest power as a late-stage research tool for interventions with identified objectives, outcomes, and data. This is not the case for evaluating whether research areas are over- or underfunded. Without an understanding of how research funding influences the likelihood and value of a discovery, or without a statement of the societal objectives for ASD research and level of risk aversion, economic analysis cannot provide a useful normative evaluation of ASD research. En ligne : http://dx.doi.org/10.1002/aur.1423 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=256
in Autism Research > 7-6 (December 2014) . - p.704-711[article] Autism Research Funding Allocation: Can Economics Tell Us If We Have Got It Right? [Texte imprimé et/ou numérique] / Jennifer D. ZWICKER, Auteur ; J. C. Herbert EMERY, Auteur . - p.704-711.
Langues : Anglais (eng)
in Autism Research > 7-6 (December 2014) . - p.704-711
Mots-clés : autism research funding economic evaluation funding allocation Index. décimale : PER Périodiques Résumé : There is a concern that the allocation of autism spectrum disorder (ASD) research funding may be misallocating resources, overemphasizing basic science at the expense of translational and clinical research. Anthony Bailey has proposed that an economic evaluation of autism research funding allocations could be beneficial for funding agencies by identifying under- or overfunded areas of research. In response to Bailey, we illustrate why economics cannot provide an objective, technical solution for identifying the “best” allocation of research resources. Economic evaluation has its greatest power as a late-stage research tool for interventions with identified objectives, outcomes, and data. This is not the case for evaluating whether research areas are over- or underfunded. Without an understanding of how research funding influences the likelihood and value of a discovery, or without a statement of the societal objectives for ASD research and level of risk aversion, economic analysis cannot provide a useful normative evaluation of ASD research. En ligne : http://dx.doi.org/10.1002/aur.1423 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=256 The population cost-effectiveness of a parenting intervention designed to prevent anxiety disorders in children / Cathrine MIHALOPOULOS in Journal of Child Psychology and Psychiatry, 56-9 (September 2015)
[article]
Titre : The population cost-effectiveness of a parenting intervention designed to prevent anxiety disorders in children Type de document : Texte imprimé et/ou numérique Auteurs : Cathrine MIHALOPOULOS, Auteur ; Theo VOS, Auteur ; Ronald M. RAPEE, Auteur ; Jane PIRKIS, Auteur ; Mary Lou CHATTERTON, Auteur ; Yu-Chen LEE, Auteur ; Rob CARTER, Auteur Article en page(s) : p.1026-1033 Langues : Anglais (eng) Mots-clés : Economic evaluation anxiety disorders children prevention Index. décimale : PER Périodiques Résumé : Background Prevention and early intervention for anxiety disorders has lagged behind many other forms of mental disorder. Recent research has demonstrated the efficacy of a parent-focussed psycho-educational programme. The programme is directed at parents of inhibited preschool children and has been shown to reduce anxiety disorders at 1 and 3 years following intervention. The current study assesses the cost-effectiveness of this intervention to determine whether it could provide value-for-money across a population. Method A cost-utility economic framework, using Disability-Adjusted-Life-Years (DALYs) as the outcome, was adopted. Economic modelling techniques were used to assess the incremental cost-effectiveness ratio (ICER) of the intervention within the Australian population context, which was modelled as add-on to current practice. The perspective was the health sector. Uncertainty was measured using multivariate probabilistic testing and key assumptions were tested using univariate sensitivity analysis. Results The median ICER for the intervention was AUD$8,000 per DALY averted with 99.8% of the uncertainty iterations falling below the threshold value-for-money criterion of AUD$50,000 per DALY averted. The results were robust to sensitivity testing. Conclusions Screening young children in a preschool setting for an inhibited temperament and providing a brief intervention to the parents of children with high levels of inhibition appears to provide very good value-for-money and worth considering in any package of preventive care. Further evaluation of this intervention under routine health service conditions will strengthen conclusions. Acceptability issues associated with this intervention, particularly to preschool staff and parents, need to be considered before wide-scale adoption is undertaken. En ligne : http://dx.doi.org/10.1111/jcpp.12438 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267
in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.1026-1033[article] The population cost-effectiveness of a parenting intervention designed to prevent anxiety disorders in children [Texte imprimé et/ou numérique] / Cathrine MIHALOPOULOS, Auteur ; Theo VOS, Auteur ; Ronald M. RAPEE, Auteur ; Jane PIRKIS, Auteur ; Mary Lou CHATTERTON, Auteur ; Yu-Chen LEE, Auteur ; Rob CARTER, Auteur . - p.1026-1033.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 56-9 (September 2015) . - p.1026-1033
Mots-clés : Economic evaluation anxiety disorders children prevention Index. décimale : PER Périodiques Résumé : Background Prevention and early intervention for anxiety disorders has lagged behind many other forms of mental disorder. Recent research has demonstrated the efficacy of a parent-focussed psycho-educational programme. The programme is directed at parents of inhibited preschool children and has been shown to reduce anxiety disorders at 1 and 3 years following intervention. The current study assesses the cost-effectiveness of this intervention to determine whether it could provide value-for-money across a population. Method A cost-utility economic framework, using Disability-Adjusted-Life-Years (DALYs) as the outcome, was adopted. Economic modelling techniques were used to assess the incremental cost-effectiveness ratio (ICER) of the intervention within the Australian population context, which was modelled as add-on to current practice. The perspective was the health sector. Uncertainty was measured using multivariate probabilistic testing and key assumptions were tested using univariate sensitivity analysis. Results The median ICER for the intervention was AUD$8,000 per DALY averted with 99.8% of the uncertainty iterations falling below the threshold value-for-money criterion of AUD$50,000 per DALY averted. The results were robust to sensitivity testing. Conclusions Screening young children in a preschool setting for an inhibited temperament and providing a brief intervention to the parents of children with high levels of inhibition appears to provide very good value-for-money and worth considering in any package of preventive care. Further evaluation of this intervention under routine health service conditions will strengthen conclusions. Acceptability issues associated with this intervention, particularly to preschool staff and parents, need to be considered before wide-scale adoption is undertaken. En ligne : http://dx.doi.org/10.1111/jcpp.12438 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=267 Societal costs of subclinical depressive symptoms in Dutch adolescents: a cost-of-illness study / Denise H. M. BODDEN in Journal of Child Psychology and Psychiatry, 63-7 (July 2022)
[article]
Titre : Societal costs of subclinical depressive symptoms in Dutch adolescents: a cost-of-illness study Type de document : Texte imprimé et/ou numérique Auteurs : Denise H. M. BODDEN, Auteur ; Marieke W. H. VAN DEN HEUVEL, Auteur ; Rutger C. M. E. ENGELS, Auteur ; Carmen D. DIRKSEN, Auteur Article en page(s) : p.771-780 Langues : Anglais (eng) Mots-clés : Adolescent Cost-Benefit Analysis Depression/epidemiology Depressive Disorder, Major Humans Reproducibility of Results Surveys and Questionnaires Adolescence depression economic evaluation Index. décimale : PER Périodiques Résumé : BACKGROUND: Subclinical depressive symptoms are highly prevalent among adolescents and are associated with negative consequences, which may pose an economic burden for society. We conducted a prevalence-based cost-of-illness study using a societal perspective to investigate the cost-of-illness of subclinical depressive symptoms among adolescents. METHODS: Using a bottom-up approach, cost questionnaires were assessed to measure costs from 237 Dutch families with an adolescent aged 11-18 with subclinical depressive symptoms (of which 34 met the criteria of a depressive disorder). The study is registered in the Dutch Trial Register (Trial NL5584/NTR6176; www.trialregister.nl/trial/5584). RESULTS: Our calculations show that adolescents with subclinical depressive symptoms cost the Dutch society more than ?42?million annually, expressed in costs related to depressive symptoms. Secondary analyses were performed to test the reliability and stability of the costs. When costs related to psychological problems were considered, the annual costs amounted to ?67?million. The total societal costs related to physical problems amounted to approximately ?126?million. All costs combined (depressive, psychological, behavioural and physical problems and other reasons) amounted to a ?243?million. Total costs were highest for physical-related problems of the adolescent (52% of the total costs), followed by psychological (28%), depressive (17%) and behavioural problems (1%). Using an international prevalence rate, societal costs related to depressive symptoms resulted in ?54?million a year. CONCLUSIONS: Cost-effective prevention programmes seem warranted given the high societal costs and risk of future costs as subclinical depressive symptoms could be a precursor of clinical depression later in life. En ligne : http://dx.doi.org/10.1111/jcpp.13517 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=477
in Journal of Child Psychology and Psychiatry > 63-7 (July 2022) . - p.771-780[article] Societal costs of subclinical depressive symptoms in Dutch adolescents: a cost-of-illness study [Texte imprimé et/ou numérique] / Denise H. M. BODDEN, Auteur ; Marieke W. H. VAN DEN HEUVEL, Auteur ; Rutger C. M. E. ENGELS, Auteur ; Carmen D. DIRKSEN, Auteur . - p.771-780.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 63-7 (July 2022) . - p.771-780
Mots-clés : Adolescent Cost-Benefit Analysis Depression/epidemiology Depressive Disorder, Major Humans Reproducibility of Results Surveys and Questionnaires Adolescence depression economic evaluation Index. décimale : PER Périodiques Résumé : BACKGROUND: Subclinical depressive symptoms are highly prevalent among adolescents and are associated with negative consequences, which may pose an economic burden for society. We conducted a prevalence-based cost-of-illness study using a societal perspective to investigate the cost-of-illness of subclinical depressive symptoms among adolescents. METHODS: Using a bottom-up approach, cost questionnaires were assessed to measure costs from 237 Dutch families with an adolescent aged 11-18 with subclinical depressive symptoms (of which 34 met the criteria of a depressive disorder). The study is registered in the Dutch Trial Register (Trial NL5584/NTR6176; www.trialregister.nl/trial/5584). RESULTS: Our calculations show that adolescents with subclinical depressive symptoms cost the Dutch society more than ?42?million annually, expressed in costs related to depressive symptoms. Secondary analyses were performed to test the reliability and stability of the costs. When costs related to psychological problems were considered, the annual costs amounted to ?67?million. The total societal costs related to physical problems amounted to approximately ?126?million. All costs combined (depressive, psychological, behavioural and physical problems and other reasons) amounted to a ?243?million. Total costs were highest for physical-related problems of the adolescent (52% of the total costs), followed by psychological (28%), depressive (17%) and behavioural problems (1%). Using an international prevalence rate, societal costs related to depressive symptoms resulted in ?54?million a year. CONCLUSIONS: Cost-effective prevention programmes seem warranted given the high societal costs and risk of future costs as subclinical depressive symptoms could be a precursor of clinical depression later in life. En ligne : http://dx.doi.org/10.1111/jcpp.13517 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=477 Cost-effectiveness of psychological interventions for children and young people with post-traumatic stress disorder / Ifigeneia MAVRANEZOULI in Journal of Child Psychology and Psychiatry, 61-6 (June 2020)
[article]
Titre : Cost-effectiveness of psychological interventions for children and young people with post-traumatic stress disorder Type de document : Texte imprimé et/ou numérique Auteurs : Ifigeneia MAVRANEZOULI, Auteur ; Odette MEGNIN-VIGGARS, Auteur ; David TRICKEY, Auteur ; Richard MEISER-STEDMAN, Auteur ; Caitlin DALY, Auteur ; Sofia DIAS, Auteur ; Sarah STOCKTON, Auteur ; Stephen PILLING, Auteur Article en page(s) : p.699-710 Langues : Anglais (eng) Mots-clés : Post-traumatic stress disorder decision-analytic modelling economic evaluation intervention Index. décimale : PER Périodiques Résumé : BACKGROUND: PTSD in youth may lead to long-lasting psychological implications, educational difficulties and increased healthcare costs. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of psychological interventions for children and young people with PTSD. METHODS: A decision-analytic model was constructed to compare costs and quality-adjusted life years (QALYs) of 10 psychological interventions and no treatment for children and young people with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion. RESULTS: Cognitive therapy for PTSD, a form of individual trauma-focused cognitive behavioural therapy (TF-CBT), appeared to be the most cost-effective intervention for children and young people with PTSD (with a probability of .78 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by narrative exposure (another form of individual TF-CBT), play therapy, and other forms of individual TF-CBT. After excluding cognitive therapy from the analysis, narrative exposure appeared to be the most cost-effective option with a .40 probability of being cost-effective amongst the remaining 10 options. EMDR, parent training and group TF-CBT occupied middle cost-effectiveness rankings. Family therapy and supportive counselling were less cost-effective than other active interventions. There was limited evidence for some interventions, in particular cognitive therapy for PTSD and parent training. CONCLUSIONS: Individual forms of TF-CBT and, to a lesser degree, play therapy appear to be cost-effective in the treatment of children and young people with PTSD. Family therapy and supportive counselling are unlikely to be cost-effective relative to other interventions. There is a need for well-conducted studies that examine the long-term clinical and cost-effectiveness of a range of psychological treatments for children and young people with PTSD. En ligne : http://dx.doi.org/10.1111/jcpp.13142 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=426
in Journal of Child Psychology and Psychiatry > 61-6 (June 2020) . - p.699-710[article] Cost-effectiveness of psychological interventions for children and young people with post-traumatic stress disorder [Texte imprimé et/ou numérique] / Ifigeneia MAVRANEZOULI, Auteur ; Odette MEGNIN-VIGGARS, Auteur ; David TRICKEY, Auteur ; Richard MEISER-STEDMAN, Auteur ; Caitlin DALY, Auteur ; Sofia DIAS, Auteur ; Sarah STOCKTON, Auteur ; Stephen PILLING, Auteur . - p.699-710.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 61-6 (June 2020) . - p.699-710
Mots-clés : Post-traumatic stress disorder decision-analytic modelling economic evaluation intervention Index. décimale : PER Périodiques Résumé : BACKGROUND: PTSD in youth may lead to long-lasting psychological implications, educational difficulties and increased healthcare costs. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of psychological interventions for children and young people with PTSD. METHODS: A decision-analytic model was constructed to compare costs and quality-adjusted life years (QALYs) of 10 psychological interventions and no treatment for children and young people with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion. RESULTS: Cognitive therapy for PTSD, a form of individual trauma-focused cognitive behavioural therapy (TF-CBT), appeared to be the most cost-effective intervention for children and young people with PTSD (with a probability of .78 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by narrative exposure (another form of individual TF-CBT), play therapy, and other forms of individual TF-CBT. After excluding cognitive therapy from the analysis, narrative exposure appeared to be the most cost-effective option with a .40 probability of being cost-effective amongst the remaining 10 options. EMDR, parent training and group TF-CBT occupied middle cost-effectiveness rankings. Family therapy and supportive counselling were less cost-effective than other active interventions. There was limited evidence for some interventions, in particular cognitive therapy for PTSD and parent training. CONCLUSIONS: Individual forms of TF-CBT and, to a lesser degree, play therapy appear to be cost-effective in the treatment of children and young people with PTSD. Family therapy and supportive counselling are unlikely to be cost-effective relative to other interventions. There is a need for well-conducted studies that examine the long-term clinical and cost-effectiveness of a range of psychological treatments for children and young people with PTSD. En ligne : http://dx.doi.org/10.1111/jcpp.13142 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=426 How do child and adolescent mental health problems influence public sector costs? Interindividual variations in a nationally representative British sample / Martin KNAPP in Journal of Child Psychology and Psychiatry, 56-6 (June 2015)
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