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    Cost-utility analyses in orthopaedic surgery

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    Authors
    Brauer, Carmen A.
    Rosen, Allison B.
    Olchanski, Natalia V.
    Neumann, Peter J.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2005-06-03
    Keywords
    Arthroplasty, Replacement
    Cost-Benefit Analysis
    Humans
    Orthopedic Procedures
    Periodicals as Topic
    Quality-Adjusted Life Years
    Biostatistics
    Epidemiology
    Health Services Research
    
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    Abstract
    BACKGROUND: The rising cost of health care has increased the need for the orthopaedic community to understand and apply economic evaluations. We critically reviewed the literature on orthopaedic cost-utility analysis to determine which subspecialty areas are represented, the cost-utility ratios that have been utilized, and the quality of the present literature. METHODS: We searched the English-language medical literature published between 1976 and 2001 for orthopaedic-related cost-utility analyses in which outcomes were reported as cost per quality-adjusted life year. Two trained reviewers independently audited each article to abstract data on the methods and reporting practices used in the study as well as the cost-utility ratios derived by the analysis. RESULTS: Our search yielded thirty-seven studies, in which 116 cost-utility ratios were presented. Eleven of the studies were investigations of treatment strategies in total joint arthroplasty. Study methods varied substantially, with only five studies (14%) including four key criteria recommended by the United States Panel on Cost-Effectiveness in Health and Medicine. According to a reader-assigned measure of study quality, cost-utility analyses in orthopaedics were of lower quality than those in other areas of medicine (p = 0.04). While the number of orthopaedic studies has increased in the last decade, the quality did not improve over time and did not differ according to subspecialty area or journal type. For the majority of the interventions that were studied, the cost-utility ratio was below the commonly used threshold of $50,000 per quality-adjusted life year for acceptable cost-effectiveness. CONCLUSIONS: Because of limitations in methodology, the current body of literature on orthopaedic cost-utility analyses has a limited ability to guide policy, but it can be useful for setting priorities and guiding research. Future research with clear and transparent reporting is needed in all subspecialty areas of orthopaedic practice.
    Source
    The Journal of Bone and Joint Surgery (American). 2005;87:1253-1259. doi:10.2106/JBJS.D.02152. Link to article on publisher's site
    DOI
    10.2106/JBJS.D.02152
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47779
    PubMed ID
    15930533
    Related Resources
    Link to Article in PubMed
    Rights
    © 2005 The Journal of Bone and Joint Surgery, Inc.
    ae974a485f413a2113503eed53cd6c53
    10.2106/JBJS.D.02152
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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