. 2019 Feb 19;19(6):1–199.

Table 3:

Summary of Results of Included Systematic Reviews for Anxiety Disorders

Author, Year	No., Type of Studies/No. of Participants	Results	Quality Assessment
Internet-delivered CBT compared with waiting list
Symptoms and Response to Treatment
Arnberg et al, 2014²⁰	Generalized anxiety disorder 4 RCTs/132	Guided iCBT vs. waiting list SMD = 0.84, 95% CI 0.45–1.23	GRADE: ⊕⊕ low
Adelman et al, 2014⁷	Generalized anxiety disorder 4 RCTs/317	iCBT vs. waiting list SMD = 1.06, 95% CI 0.82–1.30	Jadad score unclear for the subgroup of studies^a
Dedert et al, 2013²³	Generalized anxiety disorder 4 RCTs/321	iCBT vs. waiting list SMD = −0.94, 95% CI −1.34 to −0.54	Stregnth of evidence: moderate
Arnberg et al, 2014²⁰	Panic disorder 4 RCTs/132	Guided iCBT vs. waiting list Small to very large effects	GRADE: ⊕⊕ low
Adelman et al, 2014⁷	Panic disorder 8 RCTs/406	iCBT vs. waiting list SMD = 1.15, 95% CI 0.94–1.37	Jadad score unclear for the subgroup of studies^a
Arnberg et al, 2014²⁰	Social phobia 8 RCTs/356	Guided iCBT vs. waiting list SMD = 0.85, 95% CI 0.66–1.05	GRADE: ⊕⊕⊕ moderate
Adelman et al, 2014⁷	Social anxiety disorder 9 RCTs/not specified	iCBT vs. waiting list SMD = 0.91, 95% CI 0.74–1.07	Jadad score unclear for the subgroup of studies^a
Quality of Life
Richards et al, 2015²⁴	Generalized anxiety disorder 2 RCTs/157	SMD = 0.38, 95% CI 0.08–0.67	Risk of bias using the Cochrane Collaboration criteria was not reported for the subgroup of studies
Patient Dropout/Adherence
Dedert et al, 2013²³	Generalized anxiety disorder 2 RCTs/137	Guided iCBT^b: 75% completion Guided iCBT^c: 11% completion	Strength of evidence not reported
Internet-delivered CBT compared with a combination of usual care, waiting list, and/or information control
Symptoms and Response to Treatment
Andrews et al, 2018²¹	Panic disorder 12 RCTs/584	Hedges's g = 1.31, 95% CI 0.85–1.8	Low/unclear
	Social anxiety disorder 11 RCTs/950	Hedges's g = 0.92, 95% CI 0.76–1.08	Low/unclear
	Generalized anxiety disorder 9 RCTs/1,103	Hedges's g = 0.70, 95% CI 0.39–1.0	Low
	Panic disorder 7 RCTs/333	SMD = −1.08, 95% CI −1.45 to −0.72	Strength of evidence: moderate
*Quality of Life*
Dedert et al, 2013²³	Generalized anxiety disorder 3 RCTs/176	SMD = 0.57, 95% CI 0.27–0.87	Strength of evidence: low
Dedert et al, 2013²³	Panic disorder 6 RCTs/250	SMD = 0.49, 95% CI 0.23–0.75	Strength of evidence: moderate
*Patient Dropout and Treatment Adherence*
Dedert et al, 2013²³	Panic disorder 4 RCTs/313	80% of participants completed sessions when there was live support; 24–90% completed sessions when there was delayed support	Strength of evidence: not reported
Internet-delivered CBT compared with face-to-face CBT
Symptoms and Response to Treatment
Arnberg et al, 2014²⁰	Specific phobia 1 RCT/30	Guided iCBT vs. brief therapist-led exposure No change (no effect size reported)	GRADE ⊕ very low
Arnberg et al, 2014²⁰	Social phobia 1 RCT/126	Guided iCBT vs. group face-to-face CBT d = 0.41, 95% CI 0.03–0.78	GRADE: ⊕⊕ low
Dedert et al, 2013²³	Panic disorder 1 RCT/49	Guided iCBT vs. individual face-to-face CBT Not statistically significant	GRADE: ⊕ very low
	Panic disorder 1 RCT/113	Guided iCBT vs. group face-to-face CBT d = 0.00 (95% CI −0.41 to 0.41)	GRADE: ⊕ Very low
	Panic disorder 3 RCTs/248	iCBT vs. face-to-face CBT SMD = 0.06, 95% CI −0.19 to 0.31	Strength of evidence: moderate
	1 RCT/121	SMD = −0.42, 95% CI −0.87 to 0.02^d
Quality of Life
Dedert et al, 2013²³	Panic disorder 3 RCTs/239	SMD = −0.07, 95% CI −0.34 to 0.21	Strength of evidence: moderate
Internet-delivered CBT compared with active control
*Symptoms and Response to Treatment*
Kampmann et al, 2016²⁵	Social anxiety disorder Number of studies not specified/number of participants not specified	A small to medium effect was found when iCBT was compared with active control conditions at post-assessment (Hedges's g = 0.38, 95% CI 0.13–0.62, SE = 0.13, P < 0.01, k = 8) and at follow-up 2^e (Hedges's g = 0.23, 95% CI 0.04–0.43, SE = 0.10, P = 0.02; k = 5)	Risk of bias using the Cochrane Collaboration criteria was not reported for the subgroup of studies
*Quality of Life*
Kampmann et al, 2016²⁵	Social anxiety disorder Number of studies not specified/number of participants not specified	Hedges's g = 0.30, 95% CI 0.10–0.50, SE = 0.10, P < 0.01, k = 3	Risk of bias using the Cochrane Collaboration criteria was not reported for the subgroup of studies
Internet-delivered CBT compared to passive control
Symptoms and Response to Treatment
Kampmann et al, 2016²⁵	Social anxiety disorder Number of studies not specified/number of participants not specified	Hedges's g = 0.84, 95% CI 0.72–0.97, SE = 0.07, P < 0.001, k = 16 Exploratory analysis including only two studies of iCBT relative to passive control conditions at follow-up 1^f (Hedges's g = 0.12, 95% CI −0.17 to 0.42, SE = 0.15, P = 0.412, k = 2)	Risk of bias using the Cochrane Collaboration criteria was not reported for the subgroup of studies
Quality of Life
Kampmann et al, 2016²⁵	Social anxiety disorder Number of studies not specified/number of participants not specified	A medium effect for iCBT compared to passive control (Hedges's g = 0.57, 95% CI 0.21–0.93, SE = 0.31, P < 0.01, k = 2)	Risk of bias using the Cochrane Collaboration criteria was not reported for the subgroup of studies

Abbreviations: CI, confidence interval; iCBT, internet-delivered cognitive behavioural therapy; SE, standard error; SMD, standardized mean difference.

The authors of the health technology assessment were unable to extract the Jadad score for the subgroup of studies.

Real-time interactions with study technicians (nonlicensed staff) or clinicians (licensed professionals), including phone sessions, a scheduled chat on internet forums, or instant messaging.

Real-time communication with technician (nonlicensed staff) or clinician (licensed professionals) was delayed.

Internet-delivered CBT as an adjunct vs. face-to-face CBT.

Follow-up period was defined as 6 months and greater.

Follow-up period was defined as less than 5 months.