COgnitive behavioural therapy versus standardised medical care for adults with Dissociative non-Epileptic Seizures (CODES): statistical and economic analysis plan for a randomised controlled trial

Trials. 2017 Jun 6;18(1):258. doi: 10.1186/s13063-017-2006-4.


Background: Dissociative seizures (DSs), also called psychogenic non-epileptic seizures, are a distressing and disabling problem for many patients in neurological settings with high and often unnecessary economic costs. The COgnitive behavioural therapy versus standardised medical care for adults with Dissociative non-Epileptic Seizures (CODES) trial is an evaluation of a specifically tailored psychological intervention with the aims of reducing seizure frequency and severity and improving psychological well-being in adults with DS. The aim of this paper is to report in detail the quantitative and economic analysis plan for the CODES trial, as agreed by the trial steering committee.

Methods: The CODES trial is a multicentre, pragmatic, parallel group, randomised controlled trial performed to evaluate the clinical effectiveness and cost-effectiveness of 13 sessions of cognitive behavioural therapy (CBT) plus standardised medical care (SMC) compared with SMC alone for adult outpatients with DS.

Discussion: The objectives and design of the trial are summarised, and the aims and procedures of the planned analyses are illustrated. The proposed analysis plan addresses statistical considerations such as maintaining blinding, monitoring adherence with the protocol, describing aspects of treatment and dealing with missing data. The formal analysis approach for the primary and secondary outcomes is described, as are the descriptive statistics that will be reported. This paper provides transparency to the planned inferential analyses for the CODES trial prior to the extraction of outcome data. It also provides an update to the previously published trial protocol and guidance to those conducting similar trials.

Trial registration: ISRCTN registry ISRCTN05681227 (registered on 5 March 2014); NCT02325544 (registered on 15 December 2014).

Keywords: CODES trial; Cognitive behavioural therapy; Dissociative seizures; Non-epileptic seizures; Randomised controlled trial; Statistical analysis plan.

Publication types

  • Comparative Study
  • Multicenter Study
  • Pragmatic Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Clinical Protocols
  • Cognitive Behavioral Therapy / economics*
  • Cost-Benefit Analysis
  • Data Interpretation, Statistical
  • Health Care Costs*
  • Humans
  • Models, Economic
  • Models, Statistical
  • Research Design
  • Seizures / economics*
  • Seizures / physiopathology
  • Seizures / psychology
  • Seizures / therapy*
  • Time Factors
  • Treatment Outcome
  • United Kingdom

Associated data

  • ISRCTN/ISRCTN05681227