Evidence map›Paper›PMID 25339642›Full record

Trial reportRheumatology (Oxford, England)2015

Joint protection and hand exercises for hand osteoarthritis: an economic evaluation comparing methods for the analysis of factorial trials.

Raymond Oppong, Sue Jowett, Elaine Nicholls, David G T Whitehurst, Susan Hill, Alison Hammond, Elaine M Hay, Krysia Dziedzic

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Rheumatology (Oxford, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
–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

12 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022
    Guideline
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Review
  10. Decision Making for Healthcare Resource Allocation: Joint v. Separate Decisions on Interacting Interventions.Medical decision making : an international journal of the Society for Medical Decision Making · 2018
    Article
  11. Article
  12. 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

8 authors.

Raymond OppongArthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK Arthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK.
Sue JowettArthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK Arthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK s.jowett@bham.ac.uk.
Elaine NichollsArthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK.
David G T WhitehurstArthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK Arthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK.
Susan HillArthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK.
Alison HammondArthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK.
Elaine M HayArthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK.
Krysia DziedzicArthritis Research UK Primary Care Centre, Keele University, Keele, Health Economics Unit, School of Health & Population Sciences, University of Birmingham, Birmingham, UK, Faculty of Health Sciences, Simon Fraser University, Burnaby, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada and Centre for Health Sciences Research, University of Salford, Salford, UK.

Funding

Arthritis Research UK 17958Department of Health CAT CDRF 10-018Department of Health KMRF-2014-03-002Medical Research Council G0501798Versus Arthritis 18174
6 · The paper itself

Abstract

objectivesEvidence regarding the cost-effectiveness of joint protection and hand exercises for the management of hand OA is not well established. The primary aim of this study is to assess the cost-effectiveness (cost-utility) of these management options. In addition, given the absence of consensus regarding the conduct of economic evaluation alongside factorial trials, we compare different analytical methodologies.

methodsA trial-based economic evaluation to assess the cost-utility of joint protection only, hand exercises only and joint protection plus hand exercises compared with leaflet and advice was undertaken over a 12 month period from a UK National Health Service perspective. Patient-level mean costs and mean quality-adjusted life years (QALYs) were calculated for each trial arm. Incremental cost-effectiveness ratios (ICERs) were estimated and cost-effectiveness acceptability curves were constructed. The base case analysis used a within-the-table analysis methodology. Two further methods were explored: the at-the-margins approach and a regression-based approach with or without an interaction term.

resultsMean costs (QALYs) were £58.46 (s.d. 0.662) for leaflet and advice, £92.12 (s.d. 0.659) for joint protection, £64.51 (s.d. 0.681) for hand exercises and £112.38 (s.d. 0.658) for joint protection plus hand exercises. In the base case, hand exercises were the cost-effective option, with an ICER of £318 per QALY gained. Hand exercises remained the most cost-effective management strategy when adopting alternative methodological approaches.

conclusionThis is the first trial evaluating the cost-effectiveness of occupational therapy-supported approaches to self-management for hand OA. Our findings showed that hand exercises were the most cost-effective option.

Indexed as

Hand JointsAgedCost-Benefit AnalysisFemaleHumansMaleMiddle AgedOsteoarthritisPhysical Therapy ModalitiesProtective DevicesQuality-Adjusted Life YearsRegression AnalysisState MedicineTreatment OutcomeUnited Kingdomcost-effectivenesscost-utilityfactorial trialhand osteoarthritis

Identifiers

PMID25339642
PMCPMC4416082

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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.