Evidence map›Paper›PMID 25128014›Full record

Observational studyBMC health services research2014

The impact of preoperative patient characteristics on the cost-effectiveness of total hip replacement: a cohort study.

Matthias Vogl, Rainer Wilkesmann, Christian Lausmann, Werner Plötz

Abstract readObservational Study
In one paragraph

Observational study in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Cost-effectiveness of timelyOrthopedic reviews · 2017
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Matthias VoglHelmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, P,O, Box 1129, Neuherberg 85758, Germany. matthias.vogl@helmholtz-muenchen.de.
Rainer Wilkesmann
Christian Lausmann
Werner Plötz

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo facilitate the discussion on the increasing number of total hip replacements (THR) and their effectiveness, we apply a joint evaluation of hospital case costs and health outcomes at the patient level to enable comparative effectiveness research (CER) based on the preoperative health state.

methodsIn 2012, 292 patients from a German orthopedic hospital participated in health state evaluation before and 6 months after THR, where health-related quality of life (HRQoL) and disease specific pain and dysfunction were analyzed using EQ-5D and WOMAC scores. Costs were measured with a patient-based DRG costing scheme in a prospective observation of a cohort. Costs per quality-adjusted life year (QALY) were calculated based on the preoperative WOMAC score, as preoperative health states were found to be the best predictors of QALY gains in multivariate linear regressions.

resultsMean inpatient costs of THR were 6,310 Euros for primary replacement and 7,730 Euros for inpatient lifetime costs including revisions. QALYs gained using the U.K. population preference-weighted index were 5.95. Lifetime costs per QALY were 1,300 Euros.

conclusionsThe WOMAC score and the EQ-5D score before operation were the most important predictors of QALY gains. The poorer the WOMAC score or the EQ-5D score before operation, the higher the patient benefit. Costs per QALY were far below common thresholds in all preoperative utility score groups and with all underlying calculation methodologies.

Indexed as

AgedArthroplasty, Replacement, HipComparative Effectiveness ResearchCost-Benefit AnalysisDisability EvaluationFemaleGermanyHospital CostsHumansMalePain MeasurementProspective StudiesQuality-Adjusted Life YearsQuality of LifeRisk FactorsSocioeconomic Factors

Identifiers

PMID25128014
PMCPMC4139612

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.