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Tytuł pozycji:

The use of patient-reported outcome measures to guide referral for hip and knee arthroplasty.

Tytuł:
The use of patient-reported outcome measures to guide referral for hip and knee arthroplasty.
Autorzy:
Dakin H; Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Eibich P; Nuffield Department of Population Health, University of Oxford, Oxford, UK.; Max Planck Institute for Demographic Research, Rostock, Germany.
Beard D; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, NIHR Biomedical Research Unit, University of Oxford, Oxford, UK.
Gray A; Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Price A; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, NIHR Biomedical Research Unit, University of Oxford, Oxford, UK.
Źródło:
The bone & joint journal [Bone Joint J] 2020 Jul; Vol. 102-B (7), pp. 950-958.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Original Publication: London : British Editorial Society of Bone & Joint Surgery
MeSH Terms:
Patient Reported Outcome Measures*
Quality-Adjusted Life Years*
Referral and Consultation*
Arthroplasty, Replacement, Hip/*economics
Arthroplasty, Replacement, Knee/*economics
Aged ; Cost-Benefit Analysis ; Female ; Humans ; Male ; Markov Chains ; Middle Aged ; Osteoarthritis, Hip/surgery ; Osteoarthritis, Knee/surgery ; Probability ; United Kingdom
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Grant Information:
11/63/01 United Kingdom DH_ Department of Health
Contributed Indexing:
Keywords: Arthroplasty; Cost-utility analysis; Economic evaluation; Hip; Joint arthroplasty; Knee; Osteoarthritis
Entry Date(s):
Date Created: 20200701 Date Completed: 20200713 Latest Revision: 20210316
Update Code:
20240105
PubMed Central ID:
PMC7376304
DOI:
10.1302/0301-620X.102B7.BJJ-2019-0105.R2
PMID:
32600136
Czasopismo naukowe
Aims: To assess how the cost-effectiveness of total hip arthroplasty (THA) and total knee arthroplasty (TKA) varies with age, sex, and preoperative Oxford Hip or Knee Score (OHS/OKS); and to identify the patient groups for whom THA/TKA is cost-effective.
Methods: We conducted a cost-effectiveness analysis using a Markov model from a United Kingdom NHS perspective, informed by published analyses of patient-level data. We assessed the cost-effectiveness of THA and TKA in adults with hip or knee osteoarthritis compared with having no arthroplasty surgery during the ten-year time horizon.
Results: THA and TKA cost < £7,000 per quality-adjusted life-year (QALY) gained at all preoperative scores below the absolute referral thresholds calculated previously (40 for OHS and 41 for OKS). Furthermore, THA cost < £20,000/QALY for patients with OHS of ≤ 45, while TKA was cost-effective for patients with OKS of ≤ 43, since the small improvements in quality of life outweighed the cost of surgery and any subsequent revisions. Probabilistic and one-way sensitivity analyses demonstrated that there is little uncertainty around the conclusions.
Conclusion: If society is willing to pay £20,000 per QALY gained, THA and TKA are cost-effective for nearly all patients who currently undergo surgery, including all patients at and above our calculated absolute referral thresholds. Cite this article: Bone Joint J 2020;102-B(7):950-958.

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