ArticleBMJ quality & safety2019
Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis.
Article in BMJ quality & safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04649853 (Wound Care and Pressure Injury Through the Continuum of Care), which is not on this map. Cited by 46 papers, 5 of them syntheses that pooled it.
What it found
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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.
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.
Wound Care and Pressure Injury Through the Continuum of Care
Who cites it
46 citing papers in PubMed, 5 syntheses or guidelines pooled it, 173 citations in OpenAlex.
- Economic evaluation of AI-assisted technologies in healthcare: A systematic review.Journal of food and drug analysis · 2025Pooled it
- Accuracy and clinical effectiveness of risk prediction tools for pressure injury occurrence: An umbrella review.PLoS medicine · 2025Pooled it
- Artificial intelligence in healthcare: transforming patient safety with intelligent systems-A systematic review.Frontiers in medicine · 2024Pooled it
- A Systematic Review of Economic Evaluations in Clinical Nursing Practices.Journal of nursing management · 2024Pooled it
- Turning and Repositioning Frequency to Prevent Hospital-Acquired Pressure Injuries Among Adult Patients: Systematic Review.Inquiry : a journal of medical care organization, provision and financingPooled it
- Trial
- Cost-effectiveness of multi-layered silicone foam dressings for prevention of sacral and heel pressure ulcers in high-risk intensive care unit patients: An economic analysis of a randomised controlled trial.International wound journal · 2020Trial
- Burden and Determinants of Pressure Injuries in Adult Hospitalized Patients in Oman: A Multicenter Epidemiological Study.Life (Basel, Switzerland) · 2026Article
- Evaluating Pressure Ulcer Risk With PURPOSE T in Acute Care-Inter-Rater Reliability Between Registered Nurses and Assistant Nurses.International wound journal · 2026Article
- Investigation of Pressure Injuries With Visual ChatGPT Integration: A Descriptive Cross-Sectional Study.Journal of advanced nursing · 2026Article
- Braden score at ICU admission predicts 30-day mortality in acute pancreatitis.Biomolecules & biomedicine · 2025Article
- Machine Learning in Health Economic Evaluations: Protocol for a Scoping Review.JMIR research protocols · 2025Article
- Risk factors for hospital-acquired pressure injury in neurosurgery inpatients: a real-world prospective cohort study.Scientific reports · 2025Observational
- Trend analysis of pressure ulcers in adults 60 years and older from 1990 to 2021 using jointpoint regression and Bayesian age period cohort models.Scientific reports · 2025Article
- Development of an explainable machine learning model for predicting device-related pressure injuries in clinical settings.BMC medical informatics and decision making · 2025Article
- Applications of artificial intelligence and the challenges in health technology assessment: a scoping review and framework with a focus on economic dimensions.Health economics review · 2025Review
- Using AI in the Economic Evaluation of AI-Based Health Technologies.PharmacoEconomics · 2025Article
- Feasibility and validation of a novel mobility monitoring sensor in hospitalized patients: A prospective cohort study.Journal of clinical and translational science · 2025Article
- A randomised controlled phase II trial to examine the feasibility of using hyper-oxygenated fatty acids (HOFA) to prevent facial pressure injuries from medical devices among adults admitted to intensive care-A research protocol.International wound journal · 2024Article
- Consolidated Health Economic Evaluation Reporting Standards for Interventions That Use Artificial Intelligence (CHEERS-AI).Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
Abstract
objectiveHospital-acquired pressure injuries are localised skin injuries that cause significant mortality and are costly. Nursing best practices prevent pressure injuries, including time-consuming, complex tasks that lack payment incentives. The Braden Scale is an evidence-based stratification tool nurses use daily to assess pressure-injury risk. Our objective was to analyse the cost-utility of performing repeated risk-assessment for pressure-injury prevention in all patients or high-risk groups.
designCost-utility analysis using Markov modelling from US societal and healthcare sector perspectives within a 1-year time horizon.
settingPatient-level longitudinal data on 34 787 encounters from an academic hospital electronic health record (EHR) between 2011 and 2014, including daily Braden scores. Supervised machine learning simulated age-adjusted transition probabilities between risk levels and pressure injuries.
participantsHospitalised adults with Braden scores classified into five risk levels: very high risk (6-9), high risk (10-11), moderate risk (12-14), at-risk (15-18), minimal risk (19-23).
interventionsStandard care, repeated risk assessment in all risk levels or only repeated risk assessment in high-risk strata based on machine-learning simulations.
main outcome measuresCosts (2016 $US) of pressure-injury treatment and prevention, and quality-adjusted life years (QALYs) related to pressure injuries were weighted by transition probabilities to calculate the incremental cost-effectiveness ratio (ICER) at $100 000/QALY willingness-to-pay. Univariate and probabilistic sensitivity analyses tested model uncertainty.
resultsSimulating prevention for all patients yielded greater QALYs at higher cost from societal and healthcare sector perspectives, equating to ICERs of $2000/QALY and $2142/QALY, respectively. Risk-stratified follow-up in patients with Braden scores <15 dominated standard care. Prevention for all patients was cost-effective in >99% of probabilistic simulations.
conclusionOur analysis using EHR data maintains that pressure-injury prevention for all inpatients is cost-effective. Hospitals should invest in nursing compliance with international prevention guidelines.
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Registered trials
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.