Evidence map›Paper›PMID 27390709›Full record

ArticleMedical journal of the Islamic Republic of Iran2016

The cost effectiveness of dynamic and static interspinous spacer for lumbar spinal stenosis compared with laminectomy.

Mohsen Yaghoubi, Maziar Moradi-Lakeh, Mohammad Moradi-Joo, Vafa Rahimi-Movaghar, Neda Zamani, Ahmad Naghibzadeh-Tahami

Abstract read
In one paragraph

Article in Medical journal of the Islamic Republic of Iran, 2016. 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 conservative versus surgical treatment strategies of lumbar spinal stenosis in the Swiss setting: analysis of the prospective multicenter Lumbar Stenosis Outcome Study (LSOS).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 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

6 authors.

Mohsen YaghoubiMS, Health Economic, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. mohsenyaq@yahoo.com.
Maziar Moradi-LakehMD, MPH, Associate Professor of Community Medicine, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. mazmoradi@yahoo.com.
Mohammad Moradi-JooMS, Health Technology Assessment, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. moradi2001@yahoo.com.
Vafa Rahimi-MovagharMD, Professor of Neurosurgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. v_rahimi@sina.tums.ac.ir.
Neda ZamaniMD, Community Medicine Specialist, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. nzamani@med.mui.ac.ir.
Ahmad Naghibzadeh-TahamiMS, Epidemiology Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran. naghibzadeh61@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe present study aims to evaluate the cost-effectiveness of Dynamic Interspinous Spacer (Coflex®) and Static Spacer (X-STOP ®) compared to Laminectomy (LAMI) in patients with lumbar spinal stenosis.

methodsA decision-analysis model was developed to estimate the cost-effectiveness. The effectiveness parameters were obtained from a systematic literature review in relevant databases including PUBMED and EMBASE. A meta-analysis was performed using the STATA statistical package and a random model was used to collect measures of mean difference of visual analogue scale (VAS) pain score before and after intervention in X-stop, Coflex and LAMI (95% confidence intervals). Cost data were obtained from provider and associated literature based on health care provider prospective. We assumed that the probability of the success rate of surgery in each intervention from associated literature and calculated Incremental cost effectiveness ratio. A one-way sensitivity analysis was also carried out.

resultsTwenty-four out of 294 studies are included in the Meta-analysis. The overall pooled estimate of the mean difference of VAS pain score were 3.49 (95% CI 3.7-4.2) and 4.14 (95% CI 3.09- 5.19) for X-stop and Coflex, respectively. In addition, we assumed the overall pooled estimate of 5.3 (95% CI 2.15-7.4) on the basis of literature for LAMI. The average cost per LAMI surgery, X-stop and Coflex was US$ 3019, US$ 2022 and US$ 2566, respectively. Incremental cost effectiveness ratio of X-stop and Coflex versus LAMI was US$ 665.9 and US$ 780.7, respectively.

conclusionStatic Interspinous Spacer (X-stop) appears to be the most cost-effective treatment strategy in base case scenario with success rate of LAMI (range between (55%-70%). A sensitivity analysis shows that the increase probability of success rate of LAMI was more than 70 % and less than 55% which lead to the cost effectiveness of the Coflex intervention.

Indexed as

cost-effectivenessinterspinouslaminectomylumbar vertebraespinal stenosis

Identifiers

PMID27390709
PMCPMC4898842

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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.