Evidence map›Paper›PMID 29456913›Full record

ArticleGlobal spine journal2018

Investigating the 7-Year Cost-Effectiveness of Single-Level Cervical Disc Replacement Compared to Anterior Cervical Discectomy and Fusion.

Steven J McAnany, Robert K Merrill, Samuel C Overley, Jun S Kim, Robert L Brochin, Sheeraz A Qureshi

Abstract read
In one paragraph

Article in Global spine journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 3 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

6 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Cost-effectiveness of anterior surgical decompression surgery for cervical degenerative disk disease: a systematic review of economic evaluations.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 · 2022
    Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. 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.

Steven J McAnanyWashington University, St Louis, MO, USA.
Robert K MerrillIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Samuel C OverleyIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Jun S KimIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Robert L BrochinIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Sheeraz A QureshiHospital for Special Surgery, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designCost-effectiveness analysis.

objectivesTo determine the 7-year cost-effectiveness of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF).

methodsWe analyzed 7-year Short Form-36 Health Survey data collected from the Prestige Cervical Disc investigational device exemption study (IDE). The SF-6D algorithm was used to convert this data into health state utilities. Costs were calculated from the payer perspective, and quality adjusted life years (QALYs) were used to represent effectiveness. A Markov transition-state model was used to evaluate the cost-effectiveness of single-level CDR versus ACDF, and a Monte Carlo simulation was performed to assess the probabilistic sensitivity of the model.

resultsCDR generated a 7-year cost of $172 989 compared to a 7-year cost of $143 714 for ACDF. CDR generated 4.53 QALYs compared to 3.85 QALYs generated by ACDF. The cost-effectiveness ratio of CDR was $38 247/QALY, while the cost-effectiveness ratio of ACDF was $37 325/QALY. The incremental cost-effectiveness ratio of CDR was $43 522/QALY, under the willingness to pay threshold of $50 000/QALY. Our probabilistic sensitivity analysis demonstrated CDR would be chosen 56% of the time based on 10 000 simulations.

conclusionsSingle-level CDR and ACDF were both cost-effective strategies at 7 years for treating degenerative conditions of the cervical spine. Both the Markov simulation and the Monte Carlo simulation demonstrate CDR to be the more cost-effective strategy at 7 years. Continued analysis of IDE data should be performed to validate long-term cost-effectiveness of these treatment strategies.

Indexed as

ACDFanterior cervical discectomy and fusionCDRcervical disc replacementcost-effectiveness

Identifiers

PMID29456913
PMCPMC5810898

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.