Cost-effectiveness of brief cognitive behaviour therapy <i>versus</i> treatment as usual in recurrent deliberate self-harm: a decision-making approach

Byford, Sarah; Knapp, Martín; Greenshields, Joel T.; Ukoumunne, Obioha C; Jones, Vanessa; Thompson, Simon G.; Tyrer, Peter; Schmidt, Ulrike; Davidson, Kate

doi:10.1017/s0033291703008183

Cited by 80 publications

(65 citation statements)

References 27 publications

(24 reference statements)

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“…CEACs can now be found in major medical journals such as BMJ [1][2][3][4][5], New England Journal of Medicine [6,7], Lancet [8], Circulation [9], Chest [10] as well as health economics and health technology assessment journals [11][12][13][14][15][16][17]. Given the widespread dissemination of this technique it is important to ensure that both analysts and potential users of the information understand the nature and interpretation of these curves.…”

Section: Introductionmentioning

confidence: 99%

Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions

2004

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Cost‐effectiveness acceptability curves (CEACs) have been widely adopted as a method to quantify and graphically represent uncertainty in economic evaluation studies of health‐care technologies. However, there remain some common fallacies regarding the nature and shape of CEACs that largely result from the ‘textbook’ illustration of the CEAC. This ‘textbook’ CEAC shows a smooth curve starting at probability 0, with an asymptote to 1 for higher money values of the health outcome (λ). But this familiar ‘ogive’ shape which makes the ‘textbook’ CEAC look like a cumulative distribution function is just one special case of the CEAC. The reality is that the CEAC can take many shapes and turns because it is a graphic transformation from the cost‐effectiveness plane, where the joint density of incremental costs and effects may ‘straddle’ quadrants with attendant discontinuities and asymptotes. In fact CEACs: (i) do not have to cut the y‐axis at 0; (ii) do not have to asymptote to 1; (iii) are not always monotonically increasing in λ; and (iv) do not represent cumulative distribution functions (cdfs). Within this paper we present a ‘gallery’ of CEACs in order to identify the fallacies and illustrate the facts surrounding the CEAC. The aim of the paper is to serve as a reference tool to accompany the increased use of CEACs within major medical journals. Copyright © 2004 John Wiley & Sons, Ltd.

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Section: Introductionmentioning

confidence: 99%

Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions

2004

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“…behaviour that have produced negative findings, 11,[13][14][15][16][17][18] although clearly another explanation is that the interventions were simply ineffective. A small number of trials have shown positive findings, but such trials are often dismissed as being of limited generalizability.…”

Section: Methodological Problems In Suicidologymentioning

confidence: 99%

“…In the absence of demonstrated cost-effectiveness data, some would argue that a reliance on cost-minimization analysis or inferences made from cost-effectiveness acceptability curves is an adequate basis for justifying use of public funds, particularly when the cost of services for self harm are so great. 17 Although the policy ideal is to implement only those policies that are cost-effective, social values are also important, particularly when the tools of economic analysis can be quite blunt. 36 …”

Section: Potential Solutionsmentioning

confidence: 99%

Policy on the prevention of suicidal behaviour; one treatment for all may be an unrealistic expectation

Pitman

2007

Journal of the Royal Society of Medicine

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“…68 One other study has been reviewed. The study by Byford and colleagues 69 was an economic evaluation alongside a clinical trial of MACT that collected costs and outcome data, but it was concerned with self-harming patients. Although BPD patients were a subgroup in this study, full economic evaluation was not undertaken for this subgroup and so it should have been excluded from this review.…”

Section: Systematic Review Of Existing Economic Literature Searchmentioning

confidence: 99%

“…Cost-effectiveness of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate selfharm: a decision-making approach 69 The Byford study is a cost-effectiveness analysis of data from an RCT [Prevention of Parasuicide by Manual-Assisted Cognitive Behaviour Therapy (POPMACT)] comparing MACT with TAU for the treatment of people with recurrent episodes of DSH. The trial was conducted by Tyrer and colleagues, 58 in five centres in Glasgow, Edinburgh, Nottingham, West London and South London.…”

Section: Byford and Colleagues (2003)mentioning

confidence: 99%

Psychological therapies including dialectical behaviour therapy for borderline personality disorder: a systematic review and preliminary economic evaluation

Brazier¹,

Tumur²,

Holmes³

et al. 2006

Health Technol Assess

116

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Cost-effectiveness of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: a decision-making approach

Abstract: Cost-effectiveness acceptability curves demonstrate that, based on the evidence currently available, to reject MACT on traditional grounds of statistical significance and to continue funding current practice has <10% chance of being the correct decision in terms of cost-effectiveness.

Cited by 80 publications

References 27 publications

Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions

Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions

Policy on the prevention of suicidal behaviour; one treatment for all may be an unrealistic expectation

Psychological therapies including dialectical behaviour therapy for borderline personality disorder: a systematic review and preliminary economic evaluation

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