ArticleNeuromodulation : journal of the International Neuromodulation Society2019
Trial Versus No Trial of Spinal Cord Stimulation for Chronic Neuropathic Pain: Cost Analysis in United Kingdom National Health Service.
Article in Neuromodulation : journal of the International Neuromodulation Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- 10-kHz High-Frequency Spinal Cord Stimulation for Adults With Chronic Noncancer Pain: A Health Technology Assessment.Ontario health technology assessment series · 2020Pooled it
- To Trial or Not to Trial Before Spinal Cord Stimulation for Chronic Neuropathic Pain: The Patients' View From the TRIAL-STIM Randomized Controlled Trial.Neuromodulation : journal of the International Neuromodulation Society · 2021Trial
- All-in-one spinal cord stimulation and its economic impact.Health economics review · 2026Article
- Spinal Cord Stimulation in Painful Diabetic Neuropathy: Advances, Outcomes, and Future Directions.Biomedicines · 2025Review
- Spinal Cord Stimulation for Intractable Chronic Limb Ischemia: A Narrative Review.Journal of cardiovascular development and disease · 2024Review
- Article
- Optimizing Healthcare Expenditure for Spinal Cord Stimulation in Italy: The Value of Battery Longevity Improvement and a Direct-to-Implant Approach.Journal of health economics and outcomes research · 2024Article
- Trial or not trial in the practice of spinal cord stimulation. That's the question.Interventional pain medicine · 2023Article
- Real-world outcomes of single-stage spinal cord stimulation in chronic pain patients: A multicentre, European case series.Interventional pain medicine · 2023Article
- Evidence-based consensus guidelines on patient selection and trial stimulation for spinal cord stimulation therapy for chronic non-cancer pain.Regional anesthesia and pain medicine · 2023Review
- Screening trials of spinal cord stimulation for neuropathic pain in England-A budget impact analysis.Frontiers in pain research (Lausanne, Switzerland) · 2022Article
- The impact of the COVID-19 pandemic on patients awaiting spinal cord stimulation surgery in the United Kingdom: a multi-centre patient survey.British journal of pain · 2021Article
- Practical Advices for Treating Chronic Pain in the Time of COVID-19: A Narrative Review Focusing on Interventional Techniques.Journal of clinical medicine · 2021Review
- Cost-Effectiveness Model Shows Superiority of Wireless Spinal Cord Stimulation Implantation Without a Separate Trial.Neuromodulation : journal of the International Neuromodulation Society · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of the current project was to evaluate the spinal cord stimulation (SCS) screening trial success rate threshold to obtain the same cost impact across two identical sets of patients following either a prolonged screening trial prior to implantation strategy or a full implant without a screening trial. MATERIALS AND
methodsA cost impact analysis was carried out from a health care perspective and considered trial to implant rates reported in the literature. Items of resource use were costed using national averages obtained from the National Health Service (NHS) reference cost data base. Cost components were added up to derive total patient level costs for the NHS. Only the costs associated with the screening trial procedures and devices were considered.
resultsThe most conservative of our estimates suggest that a failure rate of less than 15% is cost saving to the NHS. A failure rate as high as 45% can also be cost saving if the less expensive nonrechargeable SCS devices are used. All the thresholds observed represent a considerably higher screening failure rate than that reported in the latest randomized controlled trials (RCTs) of SCS. A trial to implant ratio of 91.6% could represent savings between £16,715 (upper bound 95% CI of rechargeable implantable pulse generator [IPG] cost) and £246,661 (lower bound 95% CI of nonrechargeable IPG cost) per each 100 patients by adopting an implantation only strategy.
conclusionsConsiderable savings could be obtained by adopting an implantation strategy without a screening trial. It is plausible that accounting for other factors, such as complications that can occur with a screening trial, additional savings could be achieved by choosing a straight to implant treatment strategy. Nevertheless, additional evidence is warranted to support this claim.
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What OpenQuestion holds
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.