Critical appraisal:Moorey S, Cort E, Kapari M, Monroe B, Hansford P, Mannix K, et al 2009

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Critical Appraisal

Article being appraised

Moorey S, Cort E, Kapari M, Monroe B, Hansford P, Mannix K, et al. A cluster randomized controlled trial of cognitive behaviour therapy for common mental disorders in patients with advanced cancer. Psychol Med 2009 May;39(5):713-23 Available from: http://www.ncbi.nlm.nih.gov/pubmed/18761755.


Applicable clinical question

Key Facts

Study Design

randomised controlled trial

Number of Patients:

80


Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
Moderate risk of bias Comments: Clinical nurses were randomly allocated to receive CBT training or continue treatment as usual. Patients who received treatment from a trained CBT nurse received CBT interventions whereas patients who saw nurses without CBT training received treatment as usual. The study aimed to examine 1) the effects of the nurses training on the nurses knowledge, practice and competency in CBT and 2) The effects of the training on the patients symptoms. Participants were followed up 6, 10 and 16 weeks. Multilevel statistical modelling was used to account for missing data. There was only a small number of lung patients 20 included in the study.


Size of effect
1 Reason for decision: The study had good power however it decreased through the intervention phases. Less than 10% of new patients were recruited to the study

and there were high attrition rates (43% dropped out at 6 weeks; 46 patients remained at 6 weeks; 35 remained at 10 weeks; 34 at 16 weeks) multilevel statistical modelling was use to account for for missing data. Despite these limitations there was a significant difference in primary outcome - CBT reduced anxiety experienced by terminally ill patients

Relevance of evidence
1 Additional comments: CBT reduced anxiety experienced by terminally ill patients

small number of lung cancer patients (12 in intervention group vrs 8 in control)

Result of appraisal

Jutta's tick icon.png Included




Completed by

Dr Natasha Michael MBChB MRCP MRCGP MSC


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Article
Moorey S, Cort E, Kapari M, Monroe B, Hansford P, Mannix K, et al. A cluster randomized controlled trial of cognitive behaviour therapy for common mental disorders in patients with advanced cancer. Psychol Med 2009 May;39(5):713-23 Available from: http://www.ncbi.nlm.nih.gov/pubmed/18761755.
Assigned to
User:Natasha.michael
Topic area
Guidelines:Lung cancer/Treatment/Non-small-cell stage IV inoperable
Clinical question
Form
Form:Critical appraisal


Section below only relevant for Cancer Council Project Officer

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