Skip to main content
Tessa NewsLink
Paste a health news link, or browse

Source study found

Story checked

Online approach helped patients manage anxiety after chest pain (opens in a new tab)

news-medical.net · 2026-10-02

Short answerEvidenceSource

Short answer

Mixed

Mixed.

The claims we could check match the study, but some claims were not covered by the evidence reviewed.

  • 3 supported
  • 4 not covered

Checked against the study summary. The full text wasn't available, so some details couldn't be settled either way.

Share this check

Follow the evidence trail
1
2

NewsLink checks it

Mixed

Every claim we could check holds up. Three of seven claims match the study. This overall rating is based only on the claims we could check. Four claims the study doesn't address.

  • 3 supported
  • 4 not covered
Open claim evidence
3
Then inspect each claim

Evidence layer

Claim by claim

Each claim gets a verdict. Expand it to see the evidence directly below.

7 claims in this story

Showing all 7 claimsChoose a verdict to focus the list.

Claim 1 of 7Not coveredOver 12 months, peer-supported iCBT reduced GAD-7 anxiety scores more than enhanced primary care referral; therapist-delivered CBT also improved anxiety but did not reach statistical significance versus primary care referral.View evidenceHide evidence

As stated1.22 points more on GAD-7; effect size 0.25; severe-anxiety subgroup 2.8 points more vs primary care and 2.2 points more vs therapist-delivered CBT

Why this verdict

The abstract-level profile supports the peer-supported iCBT result versus primary care referral, including the 1.22-point GAD-7 difference and effect size of 0.25. It also supports that the therapist-delivered CBT arm improved within-arm. However, the profile does not provide the therapist-delivered CBT between-group statistical comparison versus primary care referral, and it does not verify the stated 2.2-point severe-subgroup difference versus therapist-delivered CBT. Those portions require fuller evidence.

1

Study evidence

Peer-supported iCBT produced a greater adjusted mean reduction in GAD-7 over 12 months compared with recommended primary care referral.Mean difference 1.22 points (95% CI 0.01–2.43); effect size = 0.25

“The Patient-Centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room (PACER) trial was a randomized, 3-group comparative effectiveness trial conducted across 6 university health systems EDs”
2

Study evidence

Peer-supported iCBT produced a greater adjusted mean improvement in GAD-7 over 12 months than primary care referral (between-group difference 1.22 points; 95% CI, 0.01–2.43; effect size = 0.25).1.22 points (95% CI 0.01–2.43); standardized effect size 0.25

“Improvement with peer-supported iCBT was 1.22 points greater ... than primary care referral, and this effect was strongest (2.8 points) among patients with severe anxiety.”
Claim 2 of 7Not coveredThe advantage of peer-supported iCBT was more pronounced among participants who entered the study with severe anxiety.View evidenceHide evidence

As stated2.8 GAD-7 points more than enhanced primary care referral; 2.2 points more than therapist-delivered CBT

Why this verdict

The profile supports that peer-supported iCBT's effect was strongest among participants with severe baseline anxiety and gives a 2.8-point severe-subgroup difference versus primary care referral. But the abstract-level profile does not verify the claimed 2.2-point difference versus therapist-delivered CBT, nor does it provide subgroup confidence intervals, p-values, sample sizes, prespecification, interaction testing, or multiplicity handling.

1

Study evidence

Peer-supported iCBT produced a greater adjusted mean improvement in GAD-7 over 12 months than primary care referral (between-group difference 1.22 points; 95% CI, 0.01–2.43; effect size = 0.25).1.22 points (95% CI 0.01–2.43); standardized effect size 0.25

“Improvement with peer-supported iCBT was 1.22 points greater ... than primary care referral, and this effect was strongest (2.8 points) among patients with severe anxiety.”
Claim 3 of 7Not coveredThe researchers cautioned that the improvements could partly reflect changes over time or regression to the mean because the study lacked a usual-care no-intervention group.View evidenceHide evidence

Why this verdict

The profile supports that there was no usual-care no-intervention arm in the sense that the comparator was recommended primary care follow-up and all groups received psychoeducation. However, the abstract-level profile does not report that the researchers specifically cautioned about regression to the mean or time-related improvement as an explanation for within-group changes.

1

Study evidence

Peer-supported iCBT produced a greater adjusted mean reduction in GAD-7 over 12 months compared with recommended primary care referral.Mean difference 1.22 points (95% CI 0.01–2.43); effect size = 0.25

“The Patient-Centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room (PACER) trial was a randomized, 3-group comparative effectiveness trial conducted across 6 university health systems EDs”
Claim 4 of 7Not coveredCardiovascular events remained uncommon during follow-up, with seven major adverse cardiovascular events among six participants and one death unrelated to cardiac causes.View evidenceHide evidence

As stated7 major adverse cardiovascular events; 1.6% MACE rate; 1 death

Why this verdict

The supplied abstract-level profile does not report cardiovascular event counts, MACE rates, 30-day event timing, or death data. The claim may come from the full paper, but it is not verifiable from the provided abstract-level profile.

1

Study evidence

Peer-supported iCBT produced a greater adjusted mean reduction in GAD-7 over 12 months compared with recommended primary care referral.Mean difference 1.22 points (95% CI 0.01–2.43); effect size = 0.25

“The Patient-Centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room (PACER) trial was a randomized, 3-group comparative effectiveness trial conducted across 6 university health systems EDs”
Claim 5 of 7SupportedA randomized trial found peer-supported online cognitive behavioral therapy helped ease anxiety after low-risk chest pain, particularly for patients with severe anxiety.View evidenceHide evidence

Why this verdict

The abstract-level profile supports that this was a randomized 3-arm trial and that peer-supported iCBT produced a statistically significant, modest greater reduction in GAD-7 anxiety scores versus primary care referral over 12 months. It also supports that the effect was strongest among participants with severe baseline anxiety. The headline is broadly aligned with the paper, though the severe-anxiety subgroup details are limited at abstract depth.

1

Study evidence

Peer-supported iCBT produced a greater adjusted mean reduction in GAD-7 over 12 months compared with recommended primary care referral.Mean difference 1.22 points (95% CI 0.01–2.43); effect size = 0.25

“The Patient-Centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room (PACER) trial was a randomized, 3-group comparative effectiveness trial conducted across 6 university health systems EDs”
2

Study evidence

Peer-supported iCBT produced a greater adjusted mean improvement in GAD-7 over 12 months than primary care referral (between-group difference 1.22 points; 95% CI, 0.01–2.43; effect size = 0.25).1.22 points (95% CI 0.01–2.43); standardized effect size 0.25

“Improvement with peer-supported iCBT was 1.22 points greater ... than primary care referral, and this effect was strongest (2.8 points) among patients with severe anxiety.”
Claim 6 of 7SupportedThe study was a recent JAMA Internal Medicine trial of telehealth-delivered cognitive behavioral therapy interventions in patients with low-risk chest pain and anxiety.View evidenceHide evidence

Why this verdict

The profile supports that the study was a randomized comparative-effectiveness trial of telehealth-delivered CBT interventions in ED-discharged patients with low-risk chest pain and at least moderate anxiety. The supplied profile does not independently verify the journal venue or 'recent' framing, but the scientific design and population described in the claim are supported.

1

Study evidence

Peer-supported iCBT produced a greater adjusted mean reduction in GAD-7 over 12 months compared with recommended primary care referral.Mean difference 1.22 points (95% CI 0.01–2.43); effect size = 0.25

“The Patient-Centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room (PACER) trial was a randomized, 3-group comparative effectiveness trial conducted across 6 university health systems EDs”
Claim 7 of 7SupportedDepression, somatization and disability improved across all three groups, but there were no significant between-group differences for those outcomes.View evidenceHide evidence

Why this verdict

The abstract-level profile directly reports that depression, somatization, and disability improved moderately within groups, with no significant between-group differences.

1

Study evidence

Peer-supported iCBT produced a greater adjusted mean reduction in GAD-7 over 12 months compared with recommended primary care referral.Mean difference 1.22 points (95% CI 0.01–2.43); effect size = 0.25

“The Patient-Centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room (PACER) trial was a randomized, 3-group comparative effectiveness trial conducted across 6 university health systems EDs”
2

Study evidence

Odds of patient-reported global anxiety improvement were approximately three times higher in the two CBT groups compared with the primary care referral group.OR ≈ 3.0 (reported as '3 times higher odds')

“Secondary outcomes included global anxiety improvement, PHQ-8 depression scores, PHQ-14 somatization scores, and Sheehan Disability Scale scores.”
Then look for missing context

Context layer

What the story left out

Important study details the story did not include.

  • Process/implementation finding: higher engagement was associated with greater anxiety reduction, but this association is observational within the trial and may be confounded or reflect reverse causation.

    The story caveats mention inconsistent engagement, but the supplied presentation does not clearly report the paper's engagement–outcome association or its causal-interpretation limitation.

    From Within-trial secondary analyses of engagement and patient-reported process measures

11 things the story did carry across
  • Trial design and population: randomized 3-arm comparative-effectiveness trial in adults discharged from EDs with low-risk chest pain and at least moderate anxiety, comparing primary care referral, peer-supported iCBT, and therapist-delivered telehealth CBT.
  • Primary outcome: change in GAD-7 anxiety score over 12 months.
  • Primary finding: peer-supported iCBT produced a statistically significant but modest greater reduction in GAD-7 versus primary care referral: 1.22 points, 95% CI 0.01 to 2.43, effect size 0.25.
  • All three arms improved over time, including the primary care referral arm.
  • Therapist-delivered telehealth CBT showed within-arm GAD-7 improvement, but the abstract-level profile does not provide a verified statistically significant between-arm GAD-7 advantage versus primary care referral.
  • Secondary outcome: odds of patient-reported global anxiety improvement were about three times higher in both CBT groups compared with primary care referral.
  • Secondary outcomes: depression, somatization, and disability improved within groups but showed no significant between-group differences.
  • Process measures: therapeutic alliance and program satisfaction were high in both CBT groups.
  • Heterogeneity finding: the peer-supported iCBT effect was strongest among participants with severe baseline anxiety, with a 2.8-point difference versus primary care referral reported in the abstract.
  • Generalizability: the trial was conducted across 6 university health system EDs; generalizability beyond enrolled ED populations and university health system settings is not addressed in the abstract-level profile.
  • Cardiovascular event outcomes are not described in the supplied abstract-level profile.
Then read the study layer

Study layer

Study at a glance

Scan the study first. Expand only the parts you want to inspect.

Pieces of work

4

Evidence read

study summary

Lead result

human in vivo

1Lead resulthuman in vivoCompare effectiveness of two telehealth-delivered CBT approaches vs primary care referral for reducing anxiety over 12 months among ED patients discharged with low-risk chest pain and at least moderate anxiety.Randomized, 3-arm comparative effectiveness trialExpand

In plain English

Randomized, 3-arm comparative-effectiveness trial (PACER) in ED-discharged low-risk chest pain adults with at least moderate anxiety comparing recommended primary care follow-up, peer-supported internet-based CBT (iCBT), and therapist-delivered telehealth CBT. Primary outcome was change in GAD-7 over 12 months. Peer-supported iCBT produced a small but statistically significant greater 12-month GAD-7 improvement versus primary care referral (mean difference 1.22 points; 95% CI 0.01–2.43; effect size 0.25); all arms improved over time. Odds of patient-reported global anxiety improvement were ~3-fold higher in each CBT arm versus primary care referral. Depression, somatization, and disability improved within groups with no significant between-group differences. Higher engagement correlated with greater anxiety reduction; therapeutic alliance and satisfaction were high in CBT arms.

Key findings

  • Peer-supported iCBT produced a greater adjusted mean reduction in GAD-7 over 12 months compared with recommended primary care referral.Mean difference 1.22 points (95% CI 0.01–2.43); effect size = 0.25
  • All three arms showed adjusted mean within-group improvements in GAD-7 over 12 months (4.32, 5.54, and 5.13 points for primary care referral, peer-supported iCBT, and therapist-delivered CBT, respectively).
“The Patient-Centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room (PACER) trial was a randomized, 3-group comparative effectiveness trial conducted across 6 university health systems EDs”
What this piece can’t prove
  • Abstract does not provide full effect estimates (e.g., CIs) for some reported outcomes (e.g., odds of global improvement) or detailed subgroup analysis methods.

2 further details could not be confirmed from the summary.

2human in vivoAssess secondary clinical outcomes (global anxiety improvement, depression, somatization, disability) and compare these between treatment arms over follow-up.Randomized, parallel-group comparative effectiveness trial (3 arms)Expand

In plain English

In the PACER RCT, secondary clinical outcomes (patient-reported global anxiety improvement, PHQ-8 depression, PHQ-14 somatization, and Sheehan Disability Scale) were assessed longitudinally at 3, 6, 9, and 12 months. Both CBT interventions (peer-supported iCBT and therapist-delivered telehealth CBT) had higher odds of patient-reported global anxiety improvement compared with recommended primary care referral (~3-fold higher odds). Depression, somatization, and disability scores improved moderately within all arms but showed no significant between-group differences in the abstract.

Key findings

  • Odds of patient-reported global anxiety improvement were approximately three times higher in the two CBT groups compared with the primary care referral group.OR ≈ 3.0 (reported as '3 times higher odds')
  • Depression scores (PHQ-8) improved moderately within all arms over 12 months, with no significant between-group differences reported.
“Secondary outcomes included global anxiety improvement, PHQ-8 depression scores, PHQ-14 somatization scores, and Sheehan Disability Scale scores.”
What this piece can’t prove
  • Abstract does not present numerical between-group effect estimates, confidence intervals, or p-values for the secondary outcomes (PHQ-8, PHQ-14, Sheehan Disability Scale) in the quoted text.
  • Abstract does not state whether multiplicity adjustments were applied to secondary outcome analyses.

1 further detail could not be confirmed from the summary.

3human in vivoCharacterize implementation/engagement and patient-reported process measures (engagement-dose response, therapeutic alliance, and program satisfaction) in the CBT arms.Within-trial secondary analyses of engagement and patient-reported process measuresExpand

In plain English

Within the PACER randomized trial, secondary within-trial analyses examined implementation/engagement and patient-reported process measures in the two CBT telehealth arms. The abstract reports a positive association between higher engagement and greater anxiety reduction, and that therapeutic alliance and program satisfaction were high in both CBT groups; quantitative details and analytic methods for these process measures are not provided in the abstract.

Key findings

  • Higher engagement in the CBT interventions was associated with greater reduction in anxiety.
  • Therapeutic alliance and program satisfaction were reported as high in both CBT arms (peer-supported iCBT and therapist-delivered CBT).
“Higher engagement was associated with greater anxiety reduction.”
What this piece can’t prove
  • Reported association between engagement and anxiety reduction is observational within the trial and may be subject to confounding or reverse causation; the abstract does not report methods to address these issues.

2 further details could not be confirmed from the summary.

4human in vivoExamine heterogeneity of treatment effect (e.g., stronger effects among participants with severe anxiety at baseline).Randomized trial subgroup/heterogeneity assessment by baseline anxiety severityExpand

In plain English

Within the PACER randomized trial, the authors report that the benefit of peer-supported internet-based CBT versus primary care referral on GAD-7 anxiety scores was larger among participants with severe baseline anxiety; the abstract states the subgroup difference was 2.8 points (largest effect) though subgroup analysis details are not provided.

Key findings

  • Peer-supported iCBT produced a greater adjusted mean improvement in GAD-7 over 12 months than primary care referral (between-group difference 1.22 points; 95% CI, 0.01–2.43; effect size = 0.25).1.22 points (95% CI 0.01–2.43); standardized effect size 0.25
  • The abstract reports the treatment effect was strongest among patients with severe baseline anxiety, with improvement in GAD-7 2.8 points greater for peer-supported iCBT versus primary care referral.2.8 points (subgroup-specific between-group difference as reported in abstract)
“Improvement with peer-supported iCBT was 1.22 points greater ... than primary care referral, and this effect was strongest (2.8 points) among patients with severe anxiety.”
What this piece can’t prove

4 further details could not be confirmed from the summary.

Finally, the search trail

Method layer

NewsLink found the paper. Tessa takes you deeper.

NewsLink checks the story. Tessa is where you inspect the paper, authors, evidence, and research context.

Papers considered

The selected paper, plus nearby candidates.

PubMed, Europe PMC, Crossref · 15 candidate papers

Candidate

Improving primary care outcomes for Hispanics with anxiety disorders : a randomized clinical trial evaluating the effectiveness of cognitive-behavioral therapy

Crossref

Source (opens in a new tab)
Candidate

Exploring Associations Between Problematic Internet Use and Physical Symptoms Associated With Mental Disorders Among Students.

Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakologiai Egyesulet Lapja = Official Journal of the Hungarian Association of Psychopharmacology · 2026 · PubMed

Tessa (opens in a new tab)Source (opens in a new tab)

And 9 more candidates considered.