Welcome to the Big CACTUS study page

A study to assess the clinical and cost effectiveness of aphasia computer treatment versus usual stimulation or attention control long term post stroke (CACTUS)

Big CACTUS is a pragmatic randomised controlled trial (RCT) to compare outcomes for people with persistent aphasia using computerised speech and language therapy at home with those having usual care (standard speech and language therapy provision or general daily communication activity), or attention control (daily completion of puzzle book activities).

The research team, based at the University of Sheffield, with collaboration from the University of Manchester and Glasgow Caledonian University, have been awarded £1.5 million from the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme to fund the study. We are very grateful to the Tavistock Trust for Aphasia for supporting the study by providing additional key funding.

Aphasia is a communication disorder often caused by stroke. It affects the ability to understand, talk, read and write. People with aphasia rarely receive treatment from NHS speech and language therapists for more than 3 months. It has been established that people with aphasia can continue to improve their communication with prolonged treatment (beyond 12 months), but this is rarely available.

Step-by-Step is a computer program designed to help people to practise exercises to improve their ability to find the correct words when they are talking. Following a successful pilot study (CACTUS), Big CACTUS aims to compare computer therapy with attention control (puzzle books) and usual care to see if use of computer software with assistance from a volunteer/speech therapy assistant can improve the ability of people with aphasia to talk.

This research will establish whether people with aphasia can continue to improve their ability to talk after completion of traditional NHS therapy, and whether this can be achieved cost effectively by offering computer treatment at home. Potential benefits to patients include the opportunity for continued treatment and thus improved ability to talk. It could also give patients independence and control over their therapy. The NHS would benefit by being able to support a long term aphasia treatment service without increasing demand on therapy resources.

This study started recruitment in October 2014, and finished recruiting on 18th August 2016.

Recruitment to the Big CACTUS study has now finished, with a final total of 278 participants.

UPDATE: Outcome assessments with participants are still underway. Data analysis will commence December 2017, and results will be published by the end of June 2018. 

Study staff:

Name Role Site Contact
Dr Rebecca Palmer Chief Investigator

Rehabilitation and Assistive Technology (RAT) group

The University of Sheffield

r.l.palmer@sheffield.ac.uk

+44 (0)114 222 0863

Liz Cross Trial Manager

Clinical Trials Research Unit (CTRU)

The University of Sheffield

e.a.cross@sheffield.ac.uk

+44 (0)114 222 0762

Madeleine Harrison Research Assistant

Rehabilitation and Assistive Technology (RAT) group

The University of Sheffield

madeleine.harrison@sheffield.ac.uk

+44 (0)114 222 5424

Ellen Bradley Research Assistant

Clinical Trials Research Unit (CTRU)

The University of Sheffield

e.bradley@sheffield.ac.uk

+44 (0)114 222 0843

Helen Witts (maternity cover)

(Helen Hughes)

Research Speech and Language Therapist

Rehabilitation and Assistive Technology (RAT) group

The University of Sheffield

h.witts@sheffield.ac.uk

+44 (0)114 222 5425

Sarah Gonzalez Trials Support Officer

Clinical Trials Research Unit (CTRU)

The University of Sheffield

s.k.gonzalez@sheffield.ac.uk

+44 (0)114 222 0880

Kathryn Mackellar Clerical Officer

Health Services Research

The University of Sheffield

k.mackellar@sheffield.ac.uk

+44 (0)114 222 0763

Prof Cindy Cooper CTRU Director

Clinical Trials Research Unit (CTRU)

The University of Sheffield

c.l.cooper@sheffield.ac.uk

+44 (0)114 222 0743

Prof Steven Julious Senior Statistician

Medical Statistics Group (MSG)

The University of Sheffield

s.a.julious@sheffield.ac.uk

+44 (0)114 222 0709

Munya Dimairo Statistician

Medical Statistics Group (MSG)

The University of Sheffield

m.dimairo@sheffield.ac.uk

+44 (0)114 222 5204

Tim Chater Data Manager

Clinical Trials Research Unit (CTRU)

The University of Sheffield

t.chater@sheffield.ac.uk

+44 (0)114 222 0876

Chris Turtle Data Management Assistant

Clinical Trials Research Unit (CTRU)

The University of Sheffield

c.turtle@sheffield.ac.uk

+44 (0)114 222 

Nicholas Latimer Senior Health Economist

Health Economics and Decision Science (HEDS)

The University of Sheffield

N.Latimer@sheffield.ac.uk

+44 (0)114 222 0821

Abualbishr Alshreef Health Economist

Health Economics and Decision Science (HEDS)

The University of Sheffield

a.o.alshreef@sheffield.ac.uk

+44 (0)114 222 0673

Prof Pam Enderby Co-investigator The University of Sheffield

p.m.enderby@sheffield.ac.uk

+44 (0)114 222 0858

Prof Marian Brady Co-investigator Glasgow Caledonian University

M.Brady@gcu.ac.uk

+44 (0)141 331 8102

Dr Audrey Bowen Co-investigator The University of Manchester

audrey.bowen@manchester.ac.uk

+44 (0)161 206 4349

Study sites:

Site name Principal Investigator Contact
Sheffield Teaching Hospitals NHS Foundation Trust (STH)

Natascha Ullrich

natascha.bigcactus@gmail.com

07955757172

Humber NHS Foundation Trust

Anna Ray

Anna.Ray@humber.nhs.uk

01482 303669

SEPT Community Health Services Bedfordshire
(SEPT: South Essex Partnership University NHS Foundation Trust)

Niki Freedman

(South Bedfordshire)

niki@speechandlanguagetherapy.net

01582 497049

SEPT Community Health Services Bedfordshire
(SEPT: South Essex Partnership University NHS Foundation Trust)

Mary Pointer

Lead Therapist

(North Bedfordshire)

mpointerspeechtherapist@yahoo.co.uk

07712820363

NHS Greater Glasgow and Clyde (NHS GGC)

Wendy Davies

Wendy.Davies@ggc.scot.nhs.uk

0141 355 1613

Northern Health & Social Care Trust

Cathy Magee

cathy.magee@northerntrust.hscni.net

028 9055 2576

Belfast Health & Social Care Trust

Carolee McLaughlin

Carolee.McLaughlin@belfasttrust.hscni.net

028 9504 4370

Newcastle Upon Tyne Hospitals NHS Foundation Trust

Sonja Turner

Sonja.Turner2@nuth.nhs.uk

0191 229 5848

Cwm Taf University Health Board

Lucy Morgan

Lucy.Morgan4@wales.nhs.uk

01685 728451

Nottinghamshire Healthcare NHS Trust

Sally Knapp

sknapp@nhs.net

0115 9709221

Derbyshire Community Health Services NHS Trust

Helen Witts

Helen.witts@dchs.nhs.uk

01246 515554

Northern Lincolnshire & Goole NHS Foundation Trust (NLG)

Catherine Stamp

catherinestamp@nhs.net

01472 875531

City Hospitals Sunderland NHS Foundation Trust

Heather Waldron

Heather.Waldron@chsft.nhs.uk

0191 5699009

Dorset HealthCare University Foundation Trust

Lindsey Howat

lindsey.howat@dhuft.nhs.uk

01258 394084

Plymouth Community Healthcare (PCH)

Amanda Harris

amanda.harris11@nhs.net

01752 (4)34171 / (4)34301

Abertawe Bro Morgannwg University Health Board (ABMUHB)

Emma Rees

emma.rees3@wales.nhs.uk

01792 703855

Northamptonshire Healthcare Foundation Trust

Kath Gutteridge

katherine.gutteridge@nhft.nhs.uk

01604 745046

Somerset Partnership NHS Foundation Trust

Heather Hurren

Heather.hurren@sompar.nhs.uk

07766 785459

NHS Ayrshire and Arran

Ann-marie Anderson

ann-marie.anderson@aapct.scot.nhs.uk

01292 665669

Norfolk Community Health and Care NHS Trust

Tammy Davidson-Thompson

Tamara.Davidson@nchc.nhs.uk

01603 255753

Cambridgeshire & Peterborough NHS Foundation Trust

Kay Martin

kay.martin@cpft.nhs.uk

01733 776373

This project is funded by the National Institute for Health Research Health Technology Assessment Programme (12/21/01)
The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Health Technology Assessment Programme, NIHR, NHS or the Department of Health.