{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:43:03Z","timestamp":1790808183516,"version":"4.1.0"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T00:00:00Z","timestamp":1532563200000},"content-version":"unspecified","delay-in-days":206,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Technol Assess Health Care"],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:sec id=\"S0266462318000429_sec_a1\"><jats:title>Objectives:<\/jats:title><jats:p>The aim of this study was to evaluate the cost-effectiveness of exposure in vivo (EXP, a cognitive-behavioral treatment targeting pain-related fear) in Complex Regional Pain Syndrome Type I (CRPS-I), as compared to pain-contingent physical therapy (PPT).<\/jats:p><\/jats:sec><jats:sec id=\"S0266462318000429_sec_a2\" sec-type=\"methods\"><jats:title>Methods:<\/jats:title><jats:p>Data from a randomized controlled trial were used to compare the cost-effectiveness of EXP<jats:italic>versus<\/jats:italic>PPT from a societal perspective. Intervention costs, other healthcare costs, costs to patient and family, and productivity losses were included. The main outcomes were changes in the SF-36 physical component scale and quality-adjusted life-years. Changes were followed until 6 months after treatment. Uncertainty was estimated using nonparametric bootstrap analysis, cost-effectiveness acceptability curves and cost-effectiveness planes. Sensitivity analyses were performed to check robustness of findings.<\/jats:p><\/jats:sec><jats:sec id=\"S0266462318000429_sec_a3\" sec-type=\"results\"><jats:title>Results:<\/jats:title><jats:p>Forty-six patients were randomized and thirty-eight completed the study. Over 6 months, EXP resulted in greater improvement in physical health-related quality of life and quality-adjusted life-years than PPT. Despite higher initial treatment costs, EXP showed a tendency to reduce all costs compared with PPT; healthcare costs were significantly reduced. Furthermore, the cost-effectiveness planes were in favor of EXP. Sensitivity analyses, for different program costs and complete cases only, confirmed robustness of these findings.<\/jats:p><\/jats:sec><jats:sec id=\"S0266462318000429_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusions:<\/jats:title><jats:p>EXP, a cognitive-behavioral treatment, seems more cost-effective than PPT in CRPS patients with pain-related fear. The initial higher costs for EXP are offset by a long-term reduction of costs for healthcare use, and a tendency to lower work absenteeism and reduced societal costs. Due to low sample sizes, replication of findings is required to confirm results.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0266462318000429","type":"journal-article","created":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T10:53:57Z","timestamp":1532602437000},"page":"400-409","source":"Crossref","is-referenced-by-count":25,"title":["EXPOSURE IN VIVO<i>VERSUS<\/i>PAIN-CONTINGENT PHYSICAL THERAPY IN COMPLEX REGIONAL PAIN SYNDROME TYPE I: A COST-EFFECTIVENESS ANALYSIS"],"prefix":"10.1017","volume":"34","author":[{"given":"Marlies","family":"den Hollander","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noortje","family":"Heijnders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen R.","family":"de Jong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan W.S.","family":"Vlaeyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob J.E.M.","family":"Smeets","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari\u00eblle E.J.B.","family":"Goossens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,7,26]]},"reference":[{"key":"S0266462318000429_ref4","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.1998.11744781"},{"key":"S0266462318000429_ref3","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e3181958f90"},{"key":"S0266462318000429_ref2","first-page":"CD009416","article-title":"Interventions for treating pain and disability in adults with complex regional pain syndrome","author":"O'Connell","year":"2013","journal-title":"Cochrane Database Sys Rev"},{"key":"S0266462318000429_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00080-9"},{"key":"S0266462318000429_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(01)00387-6"},{"key":"S0266462318000429_ref20","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198529446.001.0001","volume-title":"Methods for the economic evaluation of health care programmes","author":"Drummond","year":"2005"},{"key":"S0266462318000429_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(03)00065-4"},{"key":"S0266462318000429_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(99)00177-8"},{"key":"S0266462318000429_ref11","volume-title":"Pain-related fear: Exposure-based treatment for chronic pain","author":"Vlaeyen","year":"2012"},{"key":"S0266462318000429_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(02)00386-X"},{"key":"S0266462318000429_ref18","unstructured":"Hakkaart-van Roijen, I , van der Linden, L , Bouwmans, C , [Kostenhandleiding. Methodologie van kostenonderzoek en referentieprijzen voor economische evaluaties in de gezondheidszorg]. Zorginstituut Nederland; 2015."},{"key":"S0266462318000429_ref27","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X13482045"},{"key":"S0266462318000429_ref8","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000282"},{"key":"S0266462318000429_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2013.05.005"},{"key":"S0266462318000429_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2015.03.014"},{"key":"S0266462318000429_ref12","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000651"},{"key":"S0266462318000429_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2014.04.006"},{"key":"S0266462318000429_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.12.009"},{"key":"S0266462318000429_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2008.06.015"},{"key":"S0266462318000429_ref29","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-1212-6"},{"key":"S0266462318000429_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2016.06.015"},{"key":"S0266462318000429_ref22","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-199304060-00006"},{"key":"S0266462318000429_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.09.008"},{"key":"S0266462318000429_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(98)00097-3"},{"key":"S0266462318000429_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-6296(01)00130-8"},{"key":"S0266462318000429_ref26","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199711000-00002"},{"key":"S0266462318000429_ref28","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462305050221"},{"key":"S0266462318000429_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.12.009"},{"key":"S0266462318000429_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2005.04.019"},{"key":"S0266462318000429_ref32","doi-asserted-by":"publisher","DOI":"10.1586\/ern.10.115"},{"key":"S0266462318000429_ref24","volume-title":"SF-36 \u00ae Physical and Mental Health Summary Scales","author":"Ware","year":"1994"},{"key":"S0266462318000429_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2012.07.001"}],"container-title":["International Journal of Technology Assessment in Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0266462318000429","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T17:21:12Z","timestamp":1720459272000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0266462318000429\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018]]}},"alternative-id":["S0266462318000429"],"URL":"https:\/\/doi.org\/10.1017\/s0266462318000429","relation":{},"ISSN":["0266-4623","1471-6348"],"issn-type":[{"value":"0266-4623","type":"print"},{"value":"1471-6348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018]]}}}