HAL Id: hal-01959769
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Preprint submitted on 19 Dec 2018
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PROSPERO International prospective register of systematic reviews A systematic review of
cost-effectiveness and cost-utility studies of telemedicine for post-traumatic stress disorder (PTSD)
Janis Hilaricus, Chris Maurice, Anna-Maria Sajin
To cite this version:
Janis Hilaricus, Chris Maurice, Anna-Maria Sajin. PROSPERO International prospective register of systematic reviews A systematic review of cost-effectiveness and cost-utility studies of telemedicine for post-traumatic stress disorder (PTSD). 2018. �hal-01959769�
PROSPERO
International prospective register of systematic reviews
A systematic review of cost-effectiveness and cost-utility studies of telemedicine for post- traumatic stress disorder (PTSD)
Janis Hilaricus, Chris Maurice, Anna-Maria Sajin
Citation
Janis Hilaricus, Chris Maurice, Anna-Maria Sajin. A systematic review of cost-effectiveness and cost-utility studies of telemedicine for post-traumatic stress disorder (PTSD). PROSPERO 2018 CRD42018096270 Available from:
http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018096270
Review question
Have telemedicine interventions been demonstrated to be cost effective compared to standard medical care in people diagnosed with post-traumatic stress disorder (PTSD)?
What is the cost-effectiveness of telemedicine compared with standard medical care in people diagnosed with post-traumatic stress disorder (PTSD)?
Searches
The NHS Economic Evaluation Database (NHS EED) and Health Technology Assessment (HTA) database (via The Cochrane Library) will be searched for studies published from inception to present. NHS EED is a comprehensive database of economic evaluations, produced by the CRD. The database stores economic evaluations and appraisals of their quality, and is therefore a comprehensive tool for reviewers of economic evaluations. NHS EED focuses solely on economic evaluations with a very precise search used to capture relevant studies across a large number of databases. Since the EED database is no longer being updated as funding has ceased, in order to ensure that economic evaluations published more recently are included, searches will also be conducted of MEDLINE, EMBASE, PsycINFO, and EconLit to identify studies published from their inception dates to the present using individualized search strategies prepared for each database.
The terms for the intervention have been taken from a previously published search strategy for telemedicine, e-health and mobile health.
The search terms for economic evaluations were taken from the Centre for Reviews and Dissemination (CRD) at the University of York.
The search strategy for PubMed using the sensitivity-maximizing RCT filter from Cochrane is presented in the associated PDF document as an example.
Studies published in English or French will be eligible for inclusion in the review.
Additional search strategy information can be found in the attached PDF document (link provided below).
Types of study to be included
Included:
Full economic evaluations, comparing at least two interventions in terms of cost-effectiveness (including cost- utility), cost-benefit and/or cost-minimisation.
Excluded:
- Studies in which the focus of treatment was mental health problems other than PTSD.
- Systematic reviews or meta-analysis.
- Studies that only addressed costs such as cost-of-illness studies.
- Studies not published in English or in French.
- Burden of illness studies and quality of life studies will be excluded.
PROSPERO
International prospective register of systematic reviews
Condition or domain being studied
Post-traumatic stress disorder is an anxiety disorder which may develop following an event where there is danger to self, or others, subjectively experienced as terrifying, horrifying or outside of one’s control (American Psychiatric Association, 2000). Symptoms of PTSD cluster into four categories:
- Persistent re-experiencing of memories of the event;
- Avoidance of distress-producing reminders of the event;
- Emotional numbing; and
- Physiological hyper-arousal, which interferes with regulation of sleep, appetite and mood (King, Leskin, King & Weathers, 1998; Naifeh, Richardson, Ben & Elhai, 2010; Simms, Watson & Doebbelling, 2002).
According to the American Telemedicine Association (http://www.americantelemed.org), telemedicine is best understood in terms of the services provided and the mechanisms used to provide those services. Here are some examples:
- Primary care and specialist referral services may involve a primary care or allied health professional providing a consultation with a patient or a specialist assisting the primary care physician in rendering a diagnosis. This may involve the use of live interactive video or the use of store and forward transmission of diagnostic images, vital signs and/or video clips along with patient data for later review.
- Remote patient monitoring, including home telehealth, uses devices to remotely collect and send data to a home health agency or a remote diagnostic testing facility (RDTF) for interpretation. Such applications might include a specific vital sign, such as blood glucose or heart ECG or a variety of indicators for homebound patients. Such services can be used to supplement the use of visiting nurses.
- Consumer medical and health information includes the use of the Internet and wireless devices for consumers to obtain specialized health information and on-line discussion groups to provide peer-to-peer support.
- Medical education provides continuing medical education credits for health professionals and special medical education seminars for targeted groups in remote locations.
Participants/population
Adults or adolescents with a primary diagnosis of PTSD defined according to DSM-IV (American Psychiatric Association, 2000) criteria following any traumatic event.
Comorbidity with other psychiatric diagnoses will not be an exclusion criterion.
Intervention(s), exposure(s)
Interventions for post-traumatic stress disorder conducted using telemedicine, mobile health or e-health.
Included:
- Cost-utility or cost-effectiveness evaluations of telemedicine, mobile health or e-health for adults and adolescent diagnosed with post-traumatic stress disorder following any traumatic event.
Excluded:
- Interventions which focus on mental health problems other than PTSD.
Comparator(s)/control
Standard medical care for post-traumatic stress disorder conducted in person.
PROSPERO
International prospective register of systematic reviews
Context
Primary outcome(s)
Incremental cost-effectiveness ratio (ICER).
Secondary outcome(s)
The probability of cost-effectiveness, total costs and total QALYs (or alternative measure of health benefit).
Data extraction (selection and coding)
A senior researcher (JH) will lead and coordinate all aspects of the review, including but not limited to preparation of the literature search, screening of relevant material, extraction and analysis of data,
interpreting the results of the meta-analytic procedures, investigating bias, and preparing the final report. A Master degree student (CM) will conduct independent duplicate screening and data extraction.
Disagreements will be resolved through discussion and consensus. One clinician/researchers (A-MS) will provide content expertise and advice on interpretation of the findings. A librarian will consult on search strategies.
A two-step process will be used to select studies. First, the project coordinator (JH) and the Master degree student (CM) will screen citation titles, abstracts, and key words, and classify each citation as “include,”
“exclude,” “unclear,” or “duplicate.” Next, the full-text reports for citations classified as “include” and
“unclear” will be read in full and a final decision on inclusion or exclusion will be made using a standardized form outlining the inclusion and exclusion criteria. The form will be pilot tested on a sample of studies early in the process.
Reference management will be performed in Zotero. At the end of the review we will construct a PRISMA flow diagram showing citations and full-text reports reviewed, included and excluded.
Comprehensive data extraction will be performed, in line with CRD guidance and the CHEERS checklist.
This includes extracting information on study methodology, limitations, evidence gaps, results and a quality assessment for critical appraisal. One reviewer will extract data independently, and a second reviewer will check 20% of the data extracted. Results will be compared and discussed and any disagreements settled by a third reviewer.
Risk of bias (quality) assessment
Data extraction will be based on the CRD guidance and the CHEERS checklist and will highlight potential bias in the evidence base. The implications of this will be discussed during dissemination.
Strategy for data synthesis
Extracted data will be summarized in text and tables. Cost figures will be extracted and converted into Euros for presentation using the price index for each country and the purchasing power parity conversion factor.
Analysis of subgroups or subsets
As well as analyzing the results of the search as a whole, each interventions will be analyzed separately.
Contact details for further information
Janis Hilaricus
hilaricusjanis@yahoo.fr
Organisational affiliation of the review
PROSPERO
International prospective register of systematic reviews Université des Antilles
Review team members and their organisational affiliations
Professor Janis Hilaricus. Université des Antilles Mr Chris Maurice. Université des Antilles
Dr Anna-Maria Sajin. Centre Hospitalier Universitaire de la Martinique
Anticipated or actual start date
01 February 2018
Anticipated completion date
01 August 2018
Funding sources/sponsors
None
Conflicts of interest
None specified.
Language
English
Country
France
Stage of review
Review_Ongoing
Subject index terms status
Subject indexing assigned by CRD
Subject index terms
Cost-Benefit Analysis; Humans; Organizations; Research; Stress Disorders, Post-Traumatic; Telemedicine
Date of registration in PROSPERO
04 June 2018
Date of publication of this version
04 June 2018
Details of any existing review of the same topic by the same authors
Stage of review at time of this submission
PROSPERO
International prospective register of systematic reviews
Stage Started Completed
Preliminary searches Yes Yes
Piloting of the study selection process No No
Formal screening of search results against eligibility criteria No No
Data extraction No No
Risk of bias (quality) assessment No No
Data analysis No No
Versions
04 June 2018
PROSPERO
This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration
record, any associated files or external websites.
