Table 2 Results of quantitative analyses per therapeutic framework and individual outcomes
Outcome | Cognition | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Intervention | k | SMD Hedges’s g (95% CI) | Significance of treatment effect | Intervention (N) | Control (N) | Heterogeneity (Chi2; I2, %) | |||||
Cognitive training | |||||||||||
Active controls | 14 | −0.32 [−0.57, −0.06] | Z = 2.43 (P = 0.02) | 425 | 476 | 44.52; 71% | |||||
Non-active (TAU or WLC) | 18 | −0.40 [−0.70, −0.11] | Z = 2.70 (P = 0.0007) | 508 | 486 | 66.06; 76% | |||||
Total | 32 | −0.36 [−0.55, −0.17] | Z = 3.69 (P = 0.0002) | 933 | 962 | 111.09; 73% | |||||
Subgroup difference: p = 0.66 | |||||||||||
Cognitive rehabilitation | |||||||||||
Active controls | 8 | −0.49 [−0.82, −0.16] | Z = 2.91 (P = 0.004) | 333 | 324 | 26.70; 74% | |||||
Non-active (TAU or WLC) | 13 | −0.81 [−1.19, −0.43] | Z = 4.21 (P < 0.0001) | 472 | 460 | 81.52; 85% | |||||
Total | 21 | −0.67 [−0.93, −0.41] | Z = 5.13 (P < 0.00001) | 805 | 704 | 111.36; 82% | |||||
Subgroup difference: p = 0.21 | |||||||||||
Virtual reality | |||||||||||
Active controls | 8 | −0.80 [−1.34, −0.25] | Z = 2.87 (P = 0.004) | 223 | 218 | 48.61; 86% | |||||
Non-active (TAU or WLC) | 5 | −0.19 [−0.66, 0.29] | Z = 0.77 (P = 0.44) | 100 | 95 | 10.28; 61% | |||||
Total | 13 | −0.55 [−0.94, −0.17] | Z = 2.83 (P = 0.005) | 323 | 313 | 62.50; 81% | |||||
Subgroup difference: p = 0.10 | |||||||||||
Videogames | |||||||||||
Total | 3 | −0.52 [−0.86, −0.18] | Z = 3.03 (P = 0.002) | 71 | 70 | 0.73; 0% | |||||
Internet-delivered cognitive behavioural therapy | |||||||||||
Total | 2 | −0.74 [−1.68, 0.20] | Z = 1.53 (P = 0.13) | 39 | 45 | 4.13; 76% | |||||
All self-guided digital interventions | |||||||||||
Total | 71 | −0.51 [−0.64, −0.37] | Z = 7.27 (P < 0.00001) | 2171 | 2174 | 301.97; 77% | |||||
Outcome | Fatigue/physical health | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Intervention | k | SMD Hedges’s g (95% CI) | Significance of treatment effect | Intervention (N) | Control (N) | Heterogeneity (Chi2; I2, %) | |||||
Cognitive training | |||||||||||
Total | 3 | 0.03 [−0.23, 0.28] | Z = 0.21 (P = 0.83) | 100 | 148 | 0.13; 0% | |||||
Cognitive rehabilitation | |||||||||||
Active controls | 2 | −0.02 [−0.30, 0.27] | Z = 0.13 (P = 0.90) | 98 | 92 | 0.45; 0% | |||||
Non-active (TAU or WLC) | 2 | −0.49 [−0.72, −0.26] | Z = 4.22 (P < 0.0001) | 154 | 154 | 0.28; 0% | |||||
Total | 4 | −0.31 [−0.61, −0.00] | Z = 1.97 (P = 0.05) | 252 | 246 | 7.15; 58% | |||||
Subgroup difference: p = 0.01 | |||||||||||
Virtual reality | |||||||||||
Total | 1 | −0.80 [−1.17, −0.43] | Z = 4.40 (P < 0.0001) | 64 | 60 | N/A | |||||
All self-guided digital interventions | |||||||||||
Total | 8 | −0.27 [−0.53, −0.02] | Z = 2.13 (P = 0.03) | 416 | 454 | 20.74; 66% | |||||
Outcome | Activities of daily living | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Intervention | k | SMD Hedges’s g (95% CI) | Significance of treatment effect | Intervention (N) | Control (N) | Heterogeneity (Chi2; I2, %) | |||||
Cognitive training | |||||||||||
Active controls | 7 | −0.03 [−0.21, 0.15] | Z = 0.30 (P = 0.76) | 225 | 268 | 1.96; 0% | |||||
Non-active (TAU or WLC) | 2 | −0.25 [−0.69, 0.18] | Z = 1.16 (P = 0.25) | 40 | 44 | 0.21; 0% | |||||
Total | 9 | −0.06 [−0.23, 0.10] | Z = 0.72 (P = 0.47) | 265 | 312 | 1.71; 0% | |||||
Subgroup difference: p = 0.34 | |||||||||||
Cognitive rehabilitation | |||||||||||
Active controls | 2 | 0.12 [−0.17, 0.41] | Z = 0.80 (P = 0.42) | 97 | 89 | 0.35; 0% | |||||
Non-active (TAU or WLC) | 3 | −0.08 [−0.33, 0.16] | Z = 0.65 (P = 0.52) | 120 | 137 | 1.44; 0% | |||||
Total | 5 | 0.00 [−0.18, 0.19] | Z = 0.02 (P = 0.98) | 217 | 226 | 2.85; 0% | |||||
Subgroup difference: p = 0.30 | |||||||||||
Virtual reality | |||||||||||
Total | 5 | −0.29 [−0.57, −0.02] | Z = 2.09 (P = 0.04) | 123 | 117 | 4.30; 7% | |||||
Internet-delivered cognitive behavioural therapy | |||||||||||
Total | 2 | −0.28 [−0.71, 0.15] | Z = 1.28 (P = 0.20) | 39 | 45 | 0.09; 0% | |||||
All self-guided digital interventions | |||||||||||
Total | 21 | −0.09 [−0.20, 0.02] | Z = 1.67 (P = 0.09) | 644 | 700 | 14.16; 0% | |||||
Outcome | Mental health (depression and anxiety) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Intervention | k | SMD Hedges’s g (95% CI) | Significance of treatment effect | Intervention (N) | Control (N) | Heterogeneity (Chi2; I2, %) | |||||
Cognitive training | |||||||||||
Active controls | 5 | −0.18 [−0.51, 0.16] | Z = 1.02 (P = 0.31) | 184 | 212 | 9.71; 59% | |||||
Non-active (TAU or WLC) | 7 | −0.45 [−0.96, 0.07] | Z = 1.69 (P = 0.09) | 173 | 173 | 32.06; 81% | |||||
Total | 12 | −0.34 [−0.65, −0.02] | Z = 2.10 (P = 0.04) | 264 | 252 | 46.04; 76% | |||||
Subgroup difference: p = 0.39 | |||||||||||
Cognitive rehabilitation | |||||||||||
Active controls | 5 | −0.28 [−0.58, 0.02] | Z = 1.80 (P = 0.07) | 241 | 235 | 9.21; 57% | |||||
Non-active (TAU or WLC) | 4 | −1.19 [−2.21, −0.17] | Z = 2.29 (P = 0.02) | 177 | 170 | 32.56; 91% | |||||
Total | 9 | −0.64 [−1.04, −0.23] | Z = 3.07 (P = 0.002) | 418 | 405 | 54.50; 85% | |||||
Subgroup difference: p = 0.09 | |||||||||||
Virtual reality | |||||||||||
Active controls | 4 | −0.52 [−0.78, −0.27] | Z = 4.00 (P < 0.0001) | 124 | 121 | 2.96; 0% | |||||
Non-active (TAU or WLC) | 3 | 0.11 [−0.33, 0.54] | Z = 0.48 (P = 0.63) | 44 | 39 | 0.55; 0% | |||||
Total | 7 | −0.36 [−0.66, −0.06] | Z = 2.37 (P = 0.02) | 168 | 160 | 9.50; 37% | |||||
Subgroup difference: p = 0.01 | |||||||||||
Internet-delivered cognitive behavioural therapy | |||||||||||
Total | 2 | −0.18 [−0.61, 0.25] | Z = 0.81 (P = 0.42) | 39 | 45 | 0.10; 0% | |||||
All self-guided digital interventions | |||||||||||
Total | 30 | −0.41 [−0.60, −0.22] | Z = 4.20 (P < 0.0001) | 982 | 995 | 115.81; 75% | |||||
Outcome | Quality of life | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Intervention | k | SMD Hedges’s g (95% CI) | Significance of treatment effect | Intervention (N) | Control (N) | Heterogeneity (Chi2; I2, %) | |||||
Cognitive training | |||||||||||
Active controls | 4 | −0.51 [−1.28, 0.25] | Z = 1.32 (P = 0.19) | 162 | 203 | 33.12; 91% | |||||
Non-active (TAU or WLC) | 4 | −0.05 [−0.37, 0.28] | Z = 0.28 (P = 0.78) | 82 | 74 | 1.03; 0% | |||||
Total | 8 | −0.29 [−0.71, 0.14] | Z = 1.37 (P = 0.17) | 244 | 277 | 35.18; 80% | |||||
Subgroup difference: p = 0.27 | |||||||||||
Cognitive rehabilitation | |||||||||||
Active controls | 3 | −0.02 [−0.25, 0.21] | Z = 0.17 (P = 0.86) | 151 | 149 | 1.18; 0% | |||||
Non-active (TAU or WLC) | 5 | −0.12 [−0.29, 0.05] | Z = 1.38 (P = 0.17) | 257 | 267 | 3.30; 0% | |||||
Total | 8 | −0.08 [−0.22, 0.05] | Z = 1.21 (P = 0.23) | 408 | 416 | 4.96; 0% | |||||
Subgroup difference: p = 0.49 | |||||||||||
Virtual reality | |||||||||||
Total | 3 | −0.38 [−1.14, 0.37] | Z = 1.00 (P = 0.32) | 102 | 93 | 10.26; 81% | |||||
Videogames | |||||||||||
Total | 2 | −0.08 [−0.51, 0.36] | Z = 0.34 (P = 0.73) | 41 | 40 | 0.09; 0% | |||||
Internet-delivered cognitive behavioural therapy | |||||||||||
Total | 1 | −0.40 [−1.12, 0.32] | Z = 1.08 (P = 0.28) | 13 | 18 | N/A | |||||
All self-guided digital interventions | |||||||||||
Total | 22 | −0.17 [−0.34, −0.00] | Z = 2.01 (P = 0.04) | 808 | 844 | 52.90; 60% | |||||
Outcome | Acceptability: treatment dropout | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Intervention | k | Odds Ratio (95% CI) | Significance of treatment effect | Intervention | Control | Heterogeneity (Chi2; I2, %) | |||||
Cognitive training | |||||||||||
Active controls | 12 | 1.23 [0.80, 1.88] | Z = 0.93 (P = 0.35) | 64/360 | 62/422 | 12.42; 11% | |||||
Non-active (TAU or WLC) | 13 | 1.53 [0.70, 3.38] | Z = 1.06 (P = 0.29) | 65/399 | 44/330 | 28.05; 54% | |||||
Total | 24 | 1.25 [0.82, 1.90] | Z = 1.04 (P = 0.30) | 129/759 | 106/752 | 40.46; 38% | |||||
Subgroup difference: p = 0.62 | |||||||||||
Cognitive rehabilitation | |||||||||||
Active controls | 5 | 1.19 [0.36, 3.90] | Z = 0.29 (P = 0.77) | 21/261 | 17/260 | 7.38; 46% | |||||
Non-active (TAU or WLC) | 8 | 1.67 [1.16, 2.42] | Z = 2.74 (P = 0.006) | 99/407 | 63/394 | 5.32; 0% | |||||
Total | 13 | 1.59 [1.10, 2.28] | Z = 2.49 (P = 0.01) | 120/668 | 80/654 | 13.29; 10% | |||||
Subgroup difference: p = 0.59 | |||||||||||
Virtual reality | |||||||||||
Active controls | 5 | 0.74 [0.24, 2.30] | Z = 0.51 (P = 0.61) | 6/117 | 8/118 | 1.11; 0% | |||||
Non-active (TAU or WLC) | 2 | 1.12 [0.19, 6.45] | Z = 0.12 (P = 0.90) | 3/34 | 2/28 | 0.48; 0% | |||||
Total | 7 | 0.84 [0.32, 2.16] | Z = 0.37 (P = 0.71) | 9/151 | 10/146 | 1.73; 0% | |||||
Subgroup difference: p = 0.70 | |||||||||||
Videogames | |||||||||||
Total | 2 | 0.30 [0.01, 7.81] | Z = 0.73 (P = 0.47) | 0/48 | 1/47 | N/A | |||||
Internet-delivered cognitive behavioural therapy | |||||||||||
Total | 2 | 1.57 [0.38, 6.53] | Z = 0.62 (P = 0.53) | 5/42 | 4/46 | 0.63; 0% | |||||
All self-guided digital interventions | |||||||||||
Total | 48 | 1.34 [1.03, 1.74] | Z = 2.19 (P = 0.03) | 262/1648 | 204/1646 | 56.57; 20% | |||||
