Internet-Delivered Psychological Pain-Management for Young Adults With Chronic Pain: An Investigation of Clinical Trial Data

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The reference group of average-age participants (aged 39-63 years) consisted of 561 participants (81% female), which was 42% of the total sample.

“This resulted in a subsample of n = 561 (81% female), which was 42% of the total sample”

• cites [31] Dear, 2017, The pain course: a randomised controlled trial comparing a remote-delivered chronic pain management program when provided in online and workbook formats, Pain sourceNot checked — no full text of the source
• cites [32] Dear, 2013, The Pain Course: a randomised controlled trial of a clinician-guided Internet-delivered cognitive behaviour therapy program for managing chronic pain and emotional well-being, Pain sourceNot checked — no full text of the source
• cites [33] Dear, 2015, The Pain Course: a randomised controlled trial examining an internet-delivered pain management program when provided with different levels of clinician support, Pain sourceDisputed

  The Methods (section 2.1, page unavailable) state that 490 participants met the trial’s inclusion criteria, with 614 people applying. A subsample of 561 therefore cannot be 42% of this paper’s participant sample; the cited passages also do not identify an average-age reference group aged 39–63. (LLM, conf=0.87)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

May combine two claims.

In recent reviews of psychological pain management for adults with chronic pain and migraine, mean ages were 50 and 39 years, respectively.

“The mean ages in recently published reviews for psychological pain management in adults with chronic pain 16 and migraine 18 were 50-and 39 years, respectively.”

• cites [16] Williams, 2020, Psychological therapies for the management of chronic pain (excluding headache) in adults, Cochrane Database Syst Rev sourceSupported
• cites [18] Sharpe, 2019, Psychological therapies for the prevention of migraine in adults, Cochrane Database Syst Rev sourceNot checked — no full text of the source

May combine two claims.

Young adults with chronic pain frequently report difficulties seeking out and accessing treatment and can wait months to years for specialist pain management care.

“Similar to adults of all ages, young adults with chronic pain frequently report difficulties seeking out and accessing treatment, 6 and can wait months to years for specialist pain management care.12,13”

• cites [6] Stinson, 2013, Understanding the information and service needs of young adults with chronic pain: perspectives of young adults and their providers, Clin J Pain sourceNot checked — no full text of the source
• cites [12] Higginson, 2019, Moving on: transition experiences of young adults with chronic pain, Can J Pain sourcePartly supported

  The Results (Collaborative systems: The bridge; page unavailable) describe a participant who was still waiting to be seen at an adult chronic pain clinic three years after joining its waiting list. This supports the possibility of a years-long wait for specialist care, but our copy does not establish the claimed months-to-years range. The separate claim about frequently reported access difficulties carries citation 6, not this source’s citation. (LLM, conf=0.82)

  Experimental — accuracy not yet measured
• cites [13] Hogg, 2012, Waiting in pain: a systematic investigation into the provision of persistent pain services in Australia, Med J Aust sourceNot checked — no full text of the source

May combine two claims.

Younger adults are less likely to complete treatment than older adults; a recent study showed young adults had 15% lower completion rates than adults over 30.

“They are also less likely to complete treatment than older adults, 24,25 with a recent study showing young adults had 15% lower completion rates than adults over 30.22”

• cites [24] Wang, 2007, Unmet need for services and interventions among adolescents with mental disorders, Am J Psychiatry sourceNot checked — no full text of the source
• cites [25] Edlund, 2002, Dropping out of mental health treatment: patterns and predictors among epidemiological survey respondents in the United States and Ontario, Am J Psychiatry sourceNot checked — no full text of the source
• cites [22] Cross, 2022, Factors associated with treatment uptake, completion, and subsequent symptom improvement in a national digital mental health service, Internet Interventions sourcePartly supported

  Table 2 in Results > Univariate analyses shows lower treatment completion among younger patients: 54.8% for ages 18–24 and 61% for ages 25–35, versus 68.3% for ages 35–45. It does not compare young adults with a single over-30 group or report a 15% lower completion rate, so the specific figure and cutoff are not supported. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

Clinical improvements were comparable within the treatment conditions of RCT2 and RCT3, so the treatment conditions were considered equal and amalgamated into one Treatment group per RCT.

“Analyses showed clinical improvements were comparable within the treatment conditions of both RCTs.Accordingly, the treatment conditions were considered equal and amalgamated into one 'Treatment' group per RCT for the purpose of this study and previously published studies.41,42”

• cites [41] Bisby, 2023, Can internet-delivered pain management programs reduce psychological distress in chronic pain? Exploring relationships between anxiety and depression, pain intensity, and disability, Pain Med sourceNot checked — no full text of the source
• cites [42] Bisby, 2023, The timing and magnitude of improvements in depression, anxiety, disability, and pain intensity during an internet-delivered program for chronic pain, J Pain sourcePartly supported

  The Participants section (page unavailable) says treatment participants from three prior RCTs received the same course and were collapsed into a single sample. The Conclusions section reports no significant difference in the timing of depression and anxiety improvement across guidance conditions. The paper does not say that conditions within RCT2 and RCT3 were deemed equal and amalgamated into one Treatment group per RCT, or that this was done in previously published studies. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

May combine two claims.

The significant improvements across outcomes seen in young adults were comparable to those seen in the average-age adult reference group who completed the same pain-management intervention and are consistent with improvements seen in the broader adult population.

“The significant improvements across outcomes seen in young adults were also comparable to those seen in the average-age adult reference group who completed the same pain-management intervention and are consistent with improvements seen in the broader adult population.16,17”

• cites [16] Williams, 2020, Psychological therapies for the management of chronic pain (excluding headache) in adults, Cochrane Database Syst Rev sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured
• cites [17] Gandy, 2022, Internet-delivered cognitive and behavioural based interventions for adults with chronic pain: a systematic review and meta-analysis of randomized controlled trials, Pain sourceNot checked — no full text of the source

May combine two claims.

The proportion of young adults accessing psychological care (33%) is higher than previous findings in North America (19%), possibly due to how individual and group mental healthcare is partially subsidised by the government in Australia.

“The proportion of young adults accessing psychological care is higher than previous findings in North America (33% vs 19%), 15 possibly due to how individual and group mental healthcare is partially subsidised by the government in Australia.53”

• cites [15] Murray, 2022, Healthcare transition among young adults with childhood-onset chronic pain: a mixed methods study and proposed framework, J Pain sourceSupported
• cites [53] Australian Government, Better Access fact sheet – professionals. Department of Health and Aged Care Australia 2019.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

In 2 studies that assessed treatment feasibility across adult age groups, uptake and completion increased by age, with significant differences between young and older adults over 60.

“For example, in 2 studies that assessed treatment feasibility across adult age groups, uptake 22 and completion 22,52 increased by age, with significant differences between young and older adults over 60.”

• cites [22] Cross, 2022, Factors associated with treatment uptake, completion, and subsequent symptom improvement in a national digital mental health service, Internet Interventions sourceSupported
• cites [52] Mewton, 2013, A naturalistic study of the acceptability and effectiveness of internet-delivered cognitive behavioural therapy for psychiatric disorders in older Australians, PLoS One sourcePartly supported

  The Abstract Results and Discussion say older adults were more likely than younger adults to complete the six iCBT lessons, supporting the completion finding attributed to this paper. The Methods describe tests for significant differences between age groups, but the retrieved passages do not report a statistically significant young-versus-over-60 completion difference. The citing sentence assigns its separate uptake finding to reference 22, not this paper. (LLM, conf=0.78)

  Experimental — accuracy not yet measured

May combine two claims.

The Patient Health Questionnaire 9-Item measure has been shown to be reliable and valid, and its internal consistency in the current study was good (α = .78).

“The measure has been shown to be both reliable and valid, 38 and internal consistency in the current study was good (α = .78).”

• cites [38] Kroenke, 2001, The PHQ-9: validity of a brief depression severity measure, J Gen Intern Med sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The percentage of participants reporting improvements of ≥30% and ≥50% was reported based on IMMPACT recommendations.

“Based on the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials recommendations, 48 the percentage of participants reporting improvements in symptoms of ≥30% and ≥50% from pre-to posttreatment for both groups and pre-treatment to follow-up for the treatment group are reported.”

• cites [48] Smith, 2020, Interpretation of chronic pain clinical trial outcomes: IMMPACT recommended considerations, Pain sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Over the 8 weeks before applying, the number of visits to any healthcare service ranged from 1 to 21.

“Over the eight weeks, the number of visits to any healthcare service ranged from 1 to 21.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The young adult sample was predominantly female (90%).

“was predominately female (90%)”

May combine two claims.

The treatment group had significant percent improvements in anxiety (95% CI: 13%, 36%) and depression (95% CI: 18%, 35%) but the control group did not (anxiety: -18%, 17%; depression: -11%, 16).

“Significant percent improvements in anxiety and depression symptoms were also found for the treatment group (95% CIs anxiety: 13%, 36%; depression: 18%, 35%) but not the control group (95% CIs anxiety: -18%, 17%; depression: -11%, 16).”

May combine two claims. The quote only partly states this claim.

At follow-up, there was no main effect of Time, indicating treatment improvements in disability were maintained at 3 months for the treatment group (P = .25), with percentage improvements (95% CI: 10%, 37%).

“At follow-up, we found no main effect of Time, indicating treatment improvements were maintained at 3-months for the treatment group (P = .25),with percentage improvements in PDI symptoms supporting this (95% CI: 10%, 37%).”

May combine two claims.

For the treatment group, there was no significant effect of Time from post-treatment to follow-up for pain intensity, suggesting improvements were maintained (P = .34).

“For the treatment group, there was no significant effect of Time from post-treatment to follow-up, suggesting improvements were maintained (P = .34).”

May combine two claims.

For anxiety and depression, GEE analyses showed significant Group-by-time interactions at post-treatment (anxiety: P < .001, d = .54; depression: P < .001, d = .67), with larger pre-post improvements in both for the treatment group compared to control.

“For anxiety and depression symptoms, GEE analyses showed significant Group-by-time interactions at posttreatment (anxiety: P < .001,d = .54;depression: P < .001,d = .67),with estimated marginal means revealing larger pre-post-treatment improvements in both anxiety and depression symptoms for the treatment group, compared to the control.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Average pain duration in the young adult sample was just under 7 years (range: 6 months to 21 years).

“Average pain duration was just under 7 years (range: 6 months to 21 years).”

Probably not a substantial claim: may not pass S3 (load-bearing).

42% of the young adult sample first experienced chronic pain as a child or adolescent (prior to age 18).

“Forty-two percent of the sample (n = 64) indicated they first experienced chronic pain as a child or adolescent (ie, prior to age 18).”

May combine two claims.

The treatment group had significant percent improvements in pain intensity (95% CI: 6%, 21%) but the control group did not (95% CI: -7%, 12%).

“Significant percent improvements were also found for the treatment group (95% CI: 6%, 21%), but not control (95% CI: -7%, 12%).”

Probably not a substantial claim: may not pass S3 (load-bearing).

A third of young adults had seen a psychologist for pain in the 8 weeks before applying.

“with a third reporting they had seen a psychologist.”

Probably not a substantial claim: may not pass S3 (load-bearing).

88% of young adults had seen their general medical practitioner for pain in the 8 weeks before applying.

“Most participants had seen their general medical practitioner (88%)”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The most common pain area reported was the back (76%), followed by the leg/foot (61%).

“The most common pain area reported was the back (76%), followed by the leg/foot (61%).”

May combine two claims.

The number of participants experiencing clinically meaningful improvements of ≥30% and ≥50% on the GAD-7 and PHQ-9 was significantly greater in the treatment group than the control group (anxiety 30%: P < .001, 50%: P = .01; depression 30%: P < .001, 50%: P < .001).

“The number of participants experiencing clinically meaningful improvements of ≥30% and ≥50% on the GAD7 and PHQ9 were significantly greater in the treatment group, compared to the control group (anxiety 30%, 50%: P < .001,P = .01;depression 30%, 50%: P < .001,P < .001,respectively).”

May combine two claims.

The number of participants with PDI scores improving by ≥30% and ≥50% was significantly greater in the treatment group than the control group at post-treatment (30%: P < .001; 50%: P < .001).

“Regarding clinical significance, the number of participants with scores on the PDI improving by ≥30% and ≥50% was significantly greater in the treatment group, than the control group at post-treatment (30%: P < .001;50%: P < .001).”

May combine two claims.

For pain-related disability, GEE analyses revealed a significant Group by Time interaction at post-treatment (P = .002, d = .68), with the treatment group showing larger pre-post improvements than controls.

“Regarding pain-related disability, GEE analyses revealed a significant Group by Time interaction at posttreatment (P = .002,d = .68).Estimated marginal means showed the treatment group had larger pre-posttreatment improvements in disability, compared to controls.”

May combine two claims.

The treatment group had significant percent improvements in disability symptoms (95% CI: 7%, 30%) but the control group did not (95% CI: -9%, 13%).

“Significant percent improvements in disability symptoms were also found for the treatment group (95% CI: 7%, 30%) but not the control group (95% CI: -9%, 13%).”

Probably not a substantial claim: may not pass S3 (load-bearing).

88% of the young adult sample reported pain in more than one location.

“The number of pain locations ranged from 1 to 10 or more, with 88% of the sample reporting pain in more than one location.”

May combine two claims.

The rate of participants experiencing ≥30% and ≥50% clinical improvements at follow-up remained stable from post-treatment for anxiety (30%: P = .51; 50%: P = .08) and depression (30%: P = .45; 50%: P = .54).

“The rate of participants experiencing ≥30% and ≥50% clinical improvements at follow-up also remained stable from post-treatment for both anxiety (30%: P = .51;50%: P = .08)and depression (30%: P = .45;50%: P = .54).”

Probably not a substantial claim: may not pass S3 (load-bearing).

70% of the young adult sample reported currently taking medication for pain at the time of application to the research trial.

“Most participants (70%) reported they were currently taking medication for pain at the time of application to the research trial”

Probably not a substantial claim: may not pass S3 (load-bearing).

38% of the young adult sample reported taking medication for their mental health.

“and 38% reported they were taking medication for their mental health.”

May combine two claims.

78% (n = 119) of all participants completed at least 4 lessons and were deemed to have adhered.

“and 78% (n = 119) completed at least 4 lessons and were deemed to have adhered.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The young adult sample had a mean age of 25.8 years (SD = 3.2 years; range 18-30 years).

“Overall, the sample had a mean age of 25.8 years (SD = 3.2 years; range 18-30 years)”

May combine two claims.

For pain intensity, GEE analyses showed a significant Group by Time interaction at post-treatment (P = .005, d = .41), with the treatment group showing larger pre-post improvements than control.

“GEE analyses for pain intensity showed a significant Group by Time interaction at post-treatment (P = .005,d = .41).Estimated marginal means showed the treatment group had larger pre-post-treatment improvements in pain intensity, compared to the control.”

May combine two claims.

The highest median number of visits to any service was 3 (physiotherapist or osteopath), with a median of 2 for most other services.

“The highest median number of visits to any service was 3 (physiotherapist or osteopath), with a median number of visits of 2 for most other services (general practitioner, nurse, psychologist, counsellor/social worker, 'other health service').”

Probably not a substantial claim: may not pass S3 (load-bearing).

58% of young adults had seen a medical specialist for pain in the 8 weeks before applying.

“and/or a medical specialist (58%)”

May combine two claims.

The treatment group had clinically meaningful reductions in symptoms for all outcomes, and these were maintained at follow-up.

“The treatment group also had clinically meaningful reductions in symptoms for all outcomes, with these maintained at follow-up.”

May combine two claims.

Post-treatment improvements were equivalent for young-adult and average-aged adult treatment groups, with no significant differences in feasibility or acceptability outcomes.

“Post-treatment improvements were equivalent for young-adult and average-aged adult treatment groups, with no significant differences in feasibility or acceptability outcomes.”

May combine two claims.

A meaningful proportion of participants did not complete treatment; over one-third of young adults did not access the final lesson.

“While we found no age effects between our 2 samples, it is important to note that a meaningful proportion of participants did not complete treatment.For example, over one-third of young adults did not access the final lesson.”

May combine two claims.

There was a significant Group by Time interaction for disability, and a posthoc comparison found no differences in demographics or baseline clinical outcome variables between participants who completed the PDI and those who did not.

“However, we found a significant Group by Time interaction for disability, and a posthoc comparison found no differences in demographics or baseline clinical outcome variables between participants who completed the PDI and those who did not (see Table S2 in Supplementary Material).”

May combine two claims.

At follow-up, there was a main effect of Time for the reference group indicating pain intensity further improved (P = .02), and it was maintained for the young-adult group (P = .22).

“We found a main effect of Time at follow-up for the reference group, indicating pain intensity further improved for this group (P = .02),and was maintained for the young-adult group (P = .22).”

May combine two claims.

The young-adult group had higher depression symptoms than the average-age group at pre-treatment (P = .05), post-treatment (P = .01), and follow-up (P = .04).

“and depression symptoms (pre: P = .05;post: P = .01;f/u: P = .04).”

May combine two claims.

In the reference group, 96% (n=541) engaged in treatment, 84% (n=472) adhered, and the non-completion rate was 26% (n=146).

“Of this group, 96% (n = 541) engaged in the treatment, and 84% (n = 472) adhered.The non-completion rate was 26% (n = 146).”

May combine two claims.

In the current study, 37%, 25%, 52%, and 47% of young adults made clinical improvements (≥30% improvements) in disability, pain intensity, depression, and anxiety, respectively, immediately post-treatment.

“For example, in the current study 37%, 25%, 52%, and 47% of young adults were found to make clinical improvements (defined as ≥30% improvements) in disability, pain intensity, depression and anxiety, respectively, immediately post-treatment.”

May combine two claims.

In the control group, 7%, 10%, 15%, and 17% made such improvements in disability, pain intensity, depression, and anxiety, respectively.

“This compared with 7%, 10%, 15%, and 17% making such improvements in disability, pain intensity, depression and anxiety, respectively, in the control group.”

May combine two claims.

The treatment group significantly improved in disability, pain intensity, anxiety symptoms, and depression symptoms post-treatment compared to the control group.

“In line with our expectations, the treatment group significantly improved in disability, pain intensity, anxiety symptoms and depression symptoms post-treatment, compared to the control group.”

May combine two claims.

Treatment engagement was high; however, around one third of participants did not complete the intervention.

“Treatment engagement was high; however, around one third of participants did not complete the intervention.”

May combine two claims.

The young-adult group had higher anxiety symptoms than the average-age group at pre-treatment (P = .001), post-treatment (P = .001), and follow-up (P = .01).

“Estimated marginal means at each timepoint revealed the young-adult group had higher anxiety symptoms (pre: P = .001;post: P = .001;f/u: P = .01)”

May combine two claims.

The treatment was deemed acceptable, with most participants endorsing they would recommend it to others with chronic pain.

“The treatment was deemed acceptable; with most endorsing they would recommend it to others with chronic pain.”

May combine two claims.

There were no significant differences between the young-adult and average-age participant groups on engagement, adherence, completion, satisfaction, perceived worth of time, or recommendation of the programme.

“Chi-square analyses indicated no significant differences between the young and averageage participant groups on engagement (χ 2 = .91,P = .34),adherence (χ 2 = 2.88, P = .09),or completion (χ 2 = 3.39, P = .07).”

• Also stated in: § Examining Age Effects on Outcomes · plain

  “Chi-square analyses indicated no significant differences between the groups on satisfaction (χ 2 = .54,P = .46),time (χ 2 = .00,P = .98),or recommendation (χ 2 = .18,P = .67).”

• Also stated in: § Discussion · plain

  “Regarding feasibility and acceptability, there were no differences between our young adult and average adult samples in rates of engagement, adherence, completion, or in treatment satisfaction.”

May combine two claims.

In the current study, 95%, 78%, 66%, and 85% of younger adults engaged, adhered, completed, and reported being satisfied with the treatment, respectively.

“In the current study, 95%, 78%, 66%, and 85% of younger adults were found to engage, adhere, complete and report being satisfied with the treatment, respectively.”

May combine two claims.

Two thirds of participants deteriorated on one outcome, and the remaining third deteriorated across 2 outcomes.

“Two thirds of participants deteriorated on one outcome, with the remaining third deteriorating across 2.”

May combine two claims.

The intervention was found to be acceptable and engagement levels were high.

“The intervention was found to be acceptable and engagement levels were high.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The four source RCTs were pre-registered on the Australian New Zealand Clinical Trials Registry.

“RCTs were pre-registered on the Australian New Zealand Clinical Trials Registry (ACTRN12611000894998; ACTRN12613000252718; ACTRN12614000768695; ACTRN12615001003561).”

• cites ACTRN12611000894998; ACTRN12613000252718; ACTRN12614000768695; ACTRN12615001003561Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The current study deviated from its protocol by reversing the aims and by conducting analyses comparing the young-adult sample with a second sample of adults from the four RCTs.

“We deviated from the protocol in the following ways: 1) the aims of the study are reversed, and we present the feasibility aim prior to clinical efficacy, and 2) we conducted analyses comparing our young-adult sample with a second sample of adults taken from the 4 RCTs.”

May combine two claims.

Less than a fifth of young adults with chronic pain surveyed were receiving psychological support, although psychological intervention remains a recommended first-line treatment.

“although psychological intervention remains a recommended first-line treatment, a recent study found that less than a fifth of young adults surveyed were receiving psychological support. 2”

• cites [2] Murray, 2022, The prevalence of chronic pain in young adults: a systematic review and meta-analysis, Pain sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

A protocol for the current study, with a data-analysis plan, was pre-registered on OSF in May 2022.

“A protocol for the current study, with a data-analysis plan, was pre-registered on OSF in May 2022 (https://doi.org/10.17605/OSF.IO/84YJQ).”

• cites https://doi.org/10.17605/OSF.IO/84YJQNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

The treatment group significantly improved across all outcomes compared with control, with improvements maintained at follow-up.

“The treatment group significant improved across all outcomes, compared with control, with improvements maintained at follow-up.”

May combine two claims.

The intervention's features (online, free, available throughout the country, transdiagnostic, limited exclusions) increase the representativeness of the sample and its applicability in the real world.

“These features increase the representativeness of the sample, and thus its applicability in the real world.”

May combine two claims.

The Pain Disability Inventory has sound psychometric properties, and its internal consistency in the current study was good (α = .86).

“The PDI has been shown to have sound psychometric properties, 36 and the internal consistency of the items in the current study was good (α = .86).”

• cites [36] Tait, 1987, The Pain Disability Index: psychometric and validity data, Arch Phys Med RehabilNot checked yet

  Not checked in the free run.

May combine two claims.

Young adults had high engagement and acceptability ratings, though 34% did not complete the intervention.

“Young adults had high engagement and acceptability ratings, though 34% did not complete the intervention.”

Classified as probably not a substantial claim. May combine two claims.

The absence of significant differences in the current study is unexpected, and caution is needed in drawing firm conclusions.

“Hence, the absence of significant differences in the current study is unexpected, and some caution is arguably needed in drawing firm conclusions just yet.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Numerical rating scales are recommended for assessing pain intensity.

“Numerical ratings scales are recommended for assessing pain intensity.40”

• cites [40] Turk, 2003, Core outcome domains for chronic pain clinical trials: IMMPACT recommendations, Pain sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Generalised Anxiety Disorder 7-Item measure has been shown to be reliable and valid for a range of anxiety disorders, and its internal consistency in the current study was excellent (α = .90).

“The measure has been shown to be both reliable and valid for a range of anxiety disorders, 37 and internal consistency in the current study was excellent (α = .90).”

• cites [37] Spitzer, 2006, A brief measure for assessing generalized anxiety disorder: the GAD-7, Arch Intern Med sourceNot checked — no full text of the source

May combine two claims.

Young adults can engage with and show improvements following a psychological pain-management intervention designed for all adults with chronic pain.

“Findings indicate young adults can engage with and show improvements following a psychological pain-management intervention designed for all adults with chronic pain.”

May combine two claims.

An Internet-delivered psychological pain-management intervention is acceptable and clinically efficacious for improving disability, anxiety, depression, and pain intensity in young adults (18-30) with chronic pain.

“Secondary analysis of data from 4 RCTs found an Internet-delivered psychological pain-management intervention acceptable and clinically efficacious for improving disability, anxiety, depression and pain intensity in young adults (18-30) with chronic pain.”

May combine two claims.

We are unable to conduct longer term evaluations of treatment efficacy and are uncertain whether the maintained improvements at 3-months follow-up are a result of the intervention or other non-treatment related factors such as increased healthcare or medication usage, or natural remission.

“We are therefore unable to conduct longer term evaluations of treatment efficacy and are uncertain whether the maintained improvements at 3-months follow-up are a result of the intervention or other non-treatment related factors such as increased healthcare or medication usage, or natural remission.”

May combine two claims.

The content of the course included adults of all ages, and outcomes were not specific to the young-adult population.

“Finally, the content of the course (eg, case stories, examples) included adults of all ages and outcomes were not specific to our population.”

May combine two claims.

Using pre-existing data allowed us to answer our research questions and determine that broad adult content was largely acceptable and efficacious for young adults.

“Using pre-exiting data allowed us to answer our research questions and determine that broad adult content was largely acceptable and efficacious for young adults.”

May combine two claims.

We were unable to report on the race, ethnicity, or gender identity of participants, so we cannot be certain how representative our sample was of emerging adults, nor whether findings would translate to all young people.

“We were unable to report on the race, ethnicity, or gender identity of participants as this information was not initially captured.Thus, we cannot be certain how representative our sample was of emerging adults, nor whether findings would translate to all young people.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

We were unable to assess whether the pattern of findings was impacted by trial cohort, or whether there were any moderators or predictors of treatment efficacy.

“Third, we were unable to assess whether the pattern of findings was impacted by trial cohort, or whether there were any moderators or predictors of treatment efficacy.”

May combine two claims.

Good clinical outcomes were observed at post-treatment and follow-up and were comparable to outcomes from a broader adult population.

“Good clinical outcomes were observed at post-treatment and follow-up and were comparable to outcomes from a broader adult population.”