Evidence map›Paper›PMID 27802289›Full record

ArticlePloS one2016

Has Metal-On-Metal Resurfacing Been a Cost-Effective Intervention for Health Care Providers?-A Registry Based Study.

Ruth Pulikottil-Jacob, Martin Connock, Ngianga-Bakwin Kandala, Hema Mistry, Amy Grove, Karoline Freeman, Matthew Costa, Paul Sutcliffe, Aileen Clarke

Abstract read
In one paragraph

Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. Review
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

9 authors.

Ruth Pulikottil-JacobWarwick Evidence, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Martin ConnockWarwick Evidence, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Ngianga-Bakwin KandalaWarwick Evidence, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Hema MistryWarwick Evidence, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Amy GroveWarwick Evidence, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Karoline FreemanWarwick Evidence, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Matthew CostaWarwick Evidence, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Paul SutcliffeWarwick Evidence, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Aileen ClarkeWarwick Evidence, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.

Funding

Department of Health WMCLAHRC-2014-1
6 · The paper itself

Abstract

backgroundTotal hip replacement for end stage arthritis of the hip is currently the most common elective surgical procedure. In 2007 about 7.5% of UK implants were metal-on-metal joint resurfacing (MoM RS) procedures. Due to poor revision performance and concerns about metal debris, the use of RS had declined by 2012 to about a 1% share of UK hip procedures. This study estimated the lifetime cost-effectiveness of metal-on-metal resurfacing (RS) procedures versus commonly employed total hip replacement (THR) methods. METHODOLOGY/PRINCIPAL

findingsWe performed a cost-utility analysis using a well-established multi-state semi-Markov model from an NHS and personal and social services perspective. We used individual patient data (IPD) from the National Joint Registry (NJR) for England and Wales on RS and THR surgery for osteoarthritis recorded from April 2003 to December 2012. We used flexible parametric modelling of NJR RS data to guide identification of patient subgroups and RS devices which delivered revision rates within the NICE 5% revision rate benchmark at 10 years. RS procedures overall have an estimated revision rate of 13% at 10 years, compared to <4% for most THR devices. New NICE guidance now recommends a revision rate benchmark of <5% at 10 years. 60% of RS implants in men and 2% in women were predicted to be within the revision benchmark. RS devices satisfying the 5% benchmark were unlikely to be cost-effective compared to THR at a standard UK willingness to pay of £20,000 per quality-adjusted life-year. However, the probability of cost effectiveness was sensitive to small changes in the costs of devices or in quality of life or revision rate estimates. CONCLUSION/SIGNIFICANCE: Our results imply that in most cases RS has not been a cost-effective resource and should probably not be adopted by decision makers concerned with the cost effectiveness of hip replacement, or by patients concerned about the likelihood of revision, regardless of patient age or gender.

Indexed as

AdultAgedArthroplasty, Replacement, HipCost-Benefit AnalysisEnglandFemaleHealth PersonnelHip ProsthesisHumansMaleMetal-on-Metal Joint ProsthesesMetalsMiddle AgedOsteoarthritis, HipProsthesis DesignProsthesis FailureMetals

Identifiers

PMID27802289
PMCPMC5089767

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.