Big CACTUS research study
A study to assess the clinical and cost effectiveness of aphasia computer treatment versus usual stimulation or attention control long term post stroke (CACTUS).
Overview
The results of the Big CACTUS study are now available! Please see the video below for a summary, or you can download our aphasia-friendly results booklet below.
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 with a total of 278 participants on 18th August 2016.
The team
| Name | Role | Site | Contact |
|---|---|---|---|
| Dr Rebecca Palmer | Chief Investigator |
Rehabilitation and Assistive Technology (RAT) group The University of Sheffield |
+44 114 222 0863 |
| Liz Cross | Trial Manager |
Clinical Trials Research Unit (CTRU) The University of Sheffield |
+44 114 222 0762 |
| Madeleine Harrison | Research Assistant |
Rehabilitation and Assistive Technology (RAT) group The University of Sheffield |
madeleine.harrison@sheffield.ac.uk +44 114 222 5424 |
| Ellen Bradley | Research Assistant |
Clinical Trials Research Unit (CTRU) The University of Sheffield |
+44 114 222 0843 |
|
Helen Witts (maternity cover) (Helen Hughes) |
Research Speech and Language Therapist |
Rehabilitation and Assistive Technology (RAT) group The University of Sheffield |
+44 114 222 5425 |
| Sarah Gonzalez | Trials Support Officer |
Clinical Trials Research Unit (CTRU) The University of Sheffield |
+44 114 222 0880 |
| Kathryn Mackellar | Clerical Officer |
Health Services Research The University of Sheffield |
+44 114 222 0763 |
| Prof Cindy Cooper | CTRU Director |
Clinical Trials Research Unit (CTRU) The University of Sheffield |
+44 114 222 0743 |
| Prof Steven Julious | Senior Statistician |
Medical Statistics Group (MSG) The University of Sheffield |
+44 114 222 0709 |
| Munya Dimairo | Statistician |
Medical Statistics Group (MSG) The University of Sheffield |
+44 114 222 5204 |
| Tim Chater | Data Manager |
Clinical Trials Research Unit (CTRU) The University of Sheffield |
+44 114 222 0876 |
| Chris Turtle | Data Management Assistant |
Clinical Trials Research Unit (CTRU) The University of Sheffield |
|
| Nicholas Latimer | Senior Health Economist |
Health Economics and Decision Science (HEDS) The University of Sheffield |
+44 114 222 0821 |
| Abualbishr Alshreef | Health Economist |
Health Economics and Decision Science (HEDS) The University of Sheffield |
+44 114 222 0673 |
| Prof Pam Enderby | Co-investigator | The University of Sheffield |
+44 114 222 0858 |
| Prof Marian Brady | Co-investigator | Glasgow Caledonian University |
+44 141 331 8102 |
| Dr Audrey Bowen | Co-investigator | The University of Manchester |
+44 161 206 4349 |
Study sites
| Site name | Principal Investigator | Contact |
|---|---|---|
| Sheffield Teaching Hospitals NHS Foundation Trust (STH) |
Natascha Ullrich |
+44 7955757172 |
| Humber NHS Foundation Trust |
Anna Ray |
+44 1482 303669 |
| SEPT Community Health Services Bedfordshire (SEPT: South Essex Partnership University NHS Foundation Trust) |
Niki Freedman (South Bedfordshire) |
niki@speechandlanguagetherapy.net +44 1582 497049 |
| SEPT Community Health Services Bedfordshire (SEPT: South Essex Partnership University NHS Foundation Trust) |
Mary Pointer Lead Therapist (North Bedfordshire) |
mpointerspeechtherapist@yahoo.co.uk +44 7712820363 |
| NHS Greater Glasgow and Clyde (NHS GGC) |
Wendy Davies |
+44 141 355 1613 |
| Northern Health & Social Care Trust |
Cathy Magee |
cathy.magee@northerntrust.hscni.net +44 28 9055 2576 |
| Belfast Health & Social Care Trust |
Carolee McLaughlin |
Carolee.McLaughlin@belfasttrust.hscni.net +44 28 9504 4370 |
| Newcastle Upon Tyne Hospitals NHS Foundation Trust |
Sonja Turner |
+44 191 229 5848 |
| Cwm Taf University Health Board |
Lucy Morgan |
+44 1685 728451 |
| Nottinghamshire Healthcare NHS Trust |
Sally Knapp |
+44 115 9709221 |
| Derbyshire Community Health Services NHS Trust |
Helen Witts |
+44 1246 515554 |
| Northern Lincolnshire & Goole NHS Foundation Trust (NLG) |
Catherine Stamp |
+44 303 3303081 |
| City Hospitals Sunderland NHS Foundation Trust |
Heather Waldron |
+44 191 5699009 |
| Dorset HealthCare University Foundation Trust |
Lindsey Howat |
+44 1258 394084 |
| Plymouth Community Healthcare (PCH) |
Amanda Harris |
+44 1752 434171 / 434301 |
| Abertawe Bro Morgannwg University Health Board (ABMUHB) |
Emma Rees |
+44 1792 703855 |
| Northamptonshire Healthcare Foundation Trust |
Kath Gutteridge |
katherine.gutteridge@nhft.nhs.uk +44 1604 745046 |
| Somerset Partnership NHS Foundation Trust |
Heather Hurren |
+44 7766 785459 |
| NHS Ayrshire and Arran |
Ann-marie Anderson |
ann-marie.anderson@aapct.scot.nhs.uk +44 1292 665669 |
| Norfolk Community Health and Care NHS Trust |
Tammy Davidson-Thompson |
+44 1603 255753 |
| Cambridgeshire & Peterborough NHS Foundation Trust |
Kay Martin |
+44 1733 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.
More information
Downloads and videos
- Big CACTUS Results Booklet (PDF, 2.7MB)
- Big CACTUS Protocol v5.0 (PDF, 1.9MB)
- Statistical Analysis Plan (SAP) v1.2 (PDF, 1.2MB)
- SAP Sign Off Sheet (PDF, 70KB)
- Frequently Asked Questions for PIs (PDF, 831KB)
- Therapy Manual: StepByStep computer therapy approach for the NHS (PDF, 2.74MB)
- PIS 1 Info sheet - patients v2 27.05.14 (PDF, 197KB)
- PIS 2 Info sheet - accessible v2 27.05.14 (PDF, 990KB)
- PIS 3 Patient info (slides) v2 27.05.14 (PDF, 1.21MB)
- PIS 4 Video: Information for assessments
- PIS 4 Video: Information for computer
- Outcome Measures Therapist Handbook (PDF, 1.51MB)