Aim
The overarching aim of the overview was to map the existing CBT systematic review evidence base and to examine if CBT produced an across-condition, general effect on HRQoL.
Objectives
To answer these research aims, the following steps were undertaken.
Step 1: data mapping
We identified all available systematic reviews of CBT and mapped these according to:
conditions (ICD-11 category, severity)
populations (age, sex, ethnicity, countries where the trials were conducted)
context (delivery format, care setting, intervention timing)
quality of the reviews.
The mapping exercise identified where there is/is not a high- or low-quality systematic review or meta-analysis of RCTs examining the effectiveness of CBT.
Step 2: panoramic meta-analysis
Reviews from step 1 that had sufficient quantitative data were entered into a PMA for the primary outcome of HRQoL and for the secondary outcomes of depression, anxiety and pain. Sensitivity analyses based on quality were performed.
If across-condition heterogeneity was not considerable, an across-condition general effect was generated for each outcome. Subgroup analyses based on age, CBT intensity, duration of follow-up and type of comparators were undertaken. We checked every within-condition and subgroup analysis to examine if there was evidence of inconsistency with the overall effect estimate.
In Chapter 6, we explore the extent to which the existing evidence base could be used to guide treatment, commissioning and research investment decisions. The aim of the patient and public input into the overview was to ensure that the overview produced work that remained rooted in the overall aim: to improve health for patients receiving CBT.
