Cost-effectiveness of implant movement analysis in aseptic loosening after hip replacement: a health-economic model.

IF 1.7 4区医学 Q3 HEALTH POLICY & SERVICES

Cost Effectiveness and Resource Allocation Pub Date : 2023-11-20 DOI:10.1186/s12962-023-00498-w

Davide Lovera, Olof Sandberg, Maziar Mohaddes, Hanna Gyllensten

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引用次数: 0

Abstract

Objective: To investigate the cost-effectiveness of using Implant Movement Analysis (IMA) to follow up suspected aseptic loosening when the diagnosis after an initial X-ray is not conclusive, compared with a diagnostic pathway with X-ray follow-up.

Methods: A health-economic model in the form of a decision tree was developed using quality-adjusted life years (QALY) from the literature, cost-per-patient data from a university hospital and the probabilities of different events from expert physicians' opinions. The base case incremental cost-effectiveness ratio (ICER) was compared with established willingness-to-pay thresholds and sensitivity analyses were performed to account for assumptions and uncertainty.

Results: The base case ICER indicated that the IMA pathway was cost effective (SEK 99,681, compared with the SEK 500,000 threshold). In the sensitivity analysis, the IMA pathway remained cost effective during most changes in parameters. ICERs above the threshold value occurred in cases where a larger or smaller proportion of people receive immediate surgery.

Conclusion: A diagnostic pathway using IMA after an inconclusive X-ray for suspected aseptic loosening was cost effective compared with a pathway with X-ray follow-up.

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髋关节置换术后无菌性松动假体运动分析的成本-效果:一个健康-经济模型。

目的:探讨在初始x线诊断不明确的情况下，采用植入物运动分析(IMA)对疑似无菌性松动进行随访与x线随访诊断途径的成本-效果比较。方法:利用文献中的质量调整生命年(QALY)、某大学医院的每位患者成本数据以及专家医生意见中不同事件的概率，建立决策树形式的健康经济模型。将基本情况下的增量成本效益比(ICER)与既定的支付意愿阈值进行比较，并进行敏感性分析，以考虑假设和不确定性。结果:基础病例ICER表明IMA途径具有成本效益(99,681瑞典克朗，而阈值为500,000瑞典克朗)。在敏感性分析中，IMA途径在大多数参数变化时仍然具有成本效益。高于阈值的ICERs发生在接受立即手术的患者比例较大或较小的情况下。结论:与x线随访的诊断途径相比，在x线不确定的情况下使用IMA诊断怀疑无菌性松动的途径更具成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cost Effectiveness and Resource Allocation HEALTH POLICY & SERVICES-

CiteScore

3.40

自引率

4.30%

发文量

审稿时长

34 weeks

期刊介绍： Cost Effectiveness and Resource Allocation is an Open Access, peer-reviewed, online journal that considers manuscripts on all aspects of cost-effectiveness analysis, including conceptual or methodological work, economic evaluations, and policy analysis related to resource allocation at a national or international level. Cost Effectiveness and Resource Allocation is aimed at health economists, health services researchers, and policy-makers with an interest in enhancing the flow and transfer of knowledge relating to efficiency in the health sector. Manuscripts are encouraged from researchers based in low- and middle-income countries, with a view to increasing the international economic evidence base for health.