An economic evaluation alongside a randomised controlled trial of Scanning Eye trAining as a Rehabilitation Choice compared to sham training for Hemianopia after stroke (the SEARCH trial)
In brief
Visual scanning training had a 67% chance of cost-effectiveness after stroke
In this trial of stroke survivors with visual field loss, scanning training had a 67% probability of being cost-effective at £20,000 per quality-adjusted life-year compared with sham training. At 26 weeks, the estimated quality-of-life gain was tiny and not statistically significant, and costs were similar; whether the training offers meaningful value remains uncertain.
- Journal
- Clinical rehabilitation (Q1)
- Published
- 30 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Fiona J Rowe, Jacob Davies, Kodchawan Doungsong, Ella Brayshaw, Michaela Brown, Kausik Chatterjee, et al.
- PMID
- 42961104
- DOI
- 10.1177/02692155261487459
Why clinicians should know about it
- Picked for Rehabilitation (top studies of the week, 1 November 2026): Economic evaluation of visual scanning after stroke
Abstract
ObjectiveTo explore the cost-effectiveness of visual scanning training for hemianopia compared to sham training.DesignRandomised controlled trial.SettingAcute stroke unit and outpatient eye clinics.ParticipantsAdult stroke survivors with homonymous hemianopia.InterventionVisual scanning training.ComparatorSham eye pursuit movements.Main measuresCost-utility and cost-effectiveness analyses were conducted from UK National Health Service (NHS) and wider societal perspectives. The primary analysis was a cost-utility analysis using EQ-5D-5L utility values. Cost-effectiveness analyses using changes in National Eye Institute-Visual Function Questionnaire-25 item composite and Brain Injury-associated Visual Impairment-Impact Questionnaire scores formed the secondary analyses.ResultsBoth intervention and sham training packages cost £9.58 (printing costs, clinician time to explain self-administration). Mean total health resource use costs at 26-weeks were higher in the intervention (£1406) than in the sham group (£1339). At 26-weeks, the intervention group gained 0.001 (95%CI:-0.018, 0.021) Quality-Adjusted Life Years (QALY) while the sham group evidenced a QALY loss of -0.002 (95%CI:-0.017, 0.012); not statistically significant (p = 0.71). The Incremental Cost-Effectiveness Ratio of visual scanning training compared to sham was £19,790/QALY, below the National Institute for Health and Care Excellence (NICE) threshold of £20,000-£30,000/QALY. Sensitivity analysis (5000 replications) suggested potential cost-effectiveness of visual scanning training, which had a 67% probability of being cost-effective at £20,000/QALY; this was not significant.ConclusionsThis is the first economic evaluation comparing visual scanning training to sham training for treating post-stroke hemianopia. While both interventions had similar costs, the costs were slightly under NICE thresholds. The intervention evidenced marginal but non-significant QALY gain over sham.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.