Statistical and health economic analysis plan for a secure care hospital evaluation of manualised (interpersonal) art-psychotherapy: the SCHEMA randomized controlled trial.

IF 2 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Trials Pub Date : 2025-07-01 DOI:10.1186/s13063-025-08934-3
Jennifer Condie, Matthew Franklin, Katie Aafjes-van Doorn, Paula Foscarini-Craggs, Iain McKinnon, Toni Leigh Harrison, Arman Iranpour, Ania Zubala, Sophie Rose, Elizabeth Randell, Rachel McNamara, Muhammad Riaz, Simon Hackett
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引用次数: 0

Abstract

Background: The SCHEMA trial evaluates whether interpersonal art psychotherapy reduces the frequency/severity of aggressive incidents or patient distress associated with psychiatric symptoms, compared to usual care.

Objective: To describe the statistical and health economic analysis plan.

Methods: A multicentre, two-arm, parallel-group, single blind individually randomised controlled trial with 150 adults within NHS secure care who have borderline to mild/moderate intellectual disability. The primary outcome is the frequency/severity of aggressive behaviour, measured on the Modified Overt Aggression Scale (MOAS) 19 weeks post-randomisation, analysed using a linear mixed-effect model, adjusted for baseline MOAS and stratification by gender and psychosis diagnosis. Changes in aggressive behaviour will be evaluated using weekly MOAS scores between 19 and 38 weeks. Patient distress relating to psychiatric symptoms will be assessed using the Brief Symptom Inventory Positive Symptom Distress Index across baseline, 19, and 38 weeks. Health-related quality-of-life will be assessed using self- and proxy-reported EQ-5D three-level (EQ-5D-3L) and Recovering Quality of Life 10-item measures, the latter to estimate the ReQoL Utility Index, across baseline, 19, and 38 weeks. The self-reported EQ-5D-3L is collected using an adapted version for people with intellectual disabilities. Resource-use is collected based on secure care records, to estimate intervention and healthcare costs over 19 and 38 weeks. HRQoL and cost data will inform cost-effectiveness based on the incremental cost per quality-adjusted life year over 38 weeks.

Discussion: This paper details the planned analyses and discusses recruitment challenges, sample size implications, and effect size assumptions. The plan was developed prior to database lock and unblinding to minimise analytical bias.

Trial registration: ISRCTN, ISRCTN57406593 . Registered on 18/01/2023.

安全护理医院评估手工(人际)艺术心理治疗的统计和卫生经济分析计划:图式随机对照试验。
背景:与常规治疗相比,图式试验评估人际艺术心理治疗是否减少了攻击性事件的频率/严重程度或患者与精神症状相关的痛苦。目的:描述统计和卫生经济分析方案。方法:一项多中心、两组、平行组、单盲、单独随机对照试验,纳入150名边缘性至轻度/中度智力残疾的NHS安全护理成年人。主要结果是攻击行为的频率/严重程度,在随机化19周后用改良显性攻击量表(MOAS)测量,使用线性混合效应模型进行分析,根据基线MOAS和性别和精神病诊断分层进行调整。攻击行为的改变将在19至38周期间使用每周MOAS评分进行评估。在基线、19周和38周期间,使用简短症状清单阳性症状困扰指数评估患者与精神症状相关的困扰。健康相关的生活质量将在基线、19周和38周期间使用自我和代理报告的EQ-5D三级(EQ-5D- 3l)和恢复生活质量10项措施进行评估,后者用于估计ReQoL效用指数。自我报告的EQ-5D-3L是使用针对智障人士的改编版本收集的。根据安全的护理记录收集资源使用情况,以估计19周和38周的干预和医疗保健费用。HRQoL和成本数据将根据超过38周的每个质量调整生命年的增量成本来告知成本效益。讨论:本文详细介绍了计划分析,并讨论了招聘挑战,样本量含义和效应大小假设。该计划是在数据库锁定和解锁之前制定的,以最大限度地减少分析偏差。试验注册:ISRCTN, ISRCTN57406593。于2023年1月18日注册
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Trials
Trials 医学-医学:研究与实验
CiteScore
3.80
自引率
4.00%
发文量
966
审稿时长
6 months
期刊介绍: Trials is an open access, peer-reviewed, online journal that will encompass all aspects of the performance and findings of randomized controlled trials. Trials will experiment with, and then refine, innovative approaches to improving communication about trials. We are keen to move beyond publishing traditional trial results articles (although these will be included). We believe this represents an exciting opportunity to advance the science and reporting of trials. Prior to 2006, Trials was published as Current Controlled Trials in Cardiovascular Medicine (CCTCVM). All published CCTCVM articles are available via the Trials website and citations to CCTCVM article URLs will continue to be supported.
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