Evidence map›Paper›PMID 32090144›Full record

ArticleThe archives of bone and joint surgery2020

Cost Effectiveness of Laminar Flow Systems for Total Shoulder Arthroplasty: Filtering Money from the OR?

Daniel E Davis, Benjamin Zmistowski, Joseph A Abboud, Surena Namdari

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The archives of bone and joint surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

4 authors.

Daniel E DavisDepartment of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.
Benjamin ZmistowskiDepartment of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.
Joseph A AbboudDepartment of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.
Surena NamdariDepartment of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaminar flow ventilation systems were developed to reduce surgical contamination in joint arthroplasty to avoid periprosthetic joint infection (PJI). The goals of this study are to evaluate the cost-effectiveness and economic viability of installing and maintaining a laminar flow system in an operating room.

methodsA Monte Carlo simulation was used to evaluate the cost effectiveness of laminar flow. The variables included were cost to treat PJI, incidence of PJI, cost of laminar flow, years of operating room use, and arthroplasty volume as the dependent variable.

resultsLaminar flow would be financially-justified when 1,217 (SD: 319) TSA cases are performed annually with assumed 10% reduction in PJI from laminar flow and 487 (SD: 127) with assumed 25% reduction. In a high volume OR, laminar flow costs $25.24 per case (assuming 10% reduction) and $8.24 per case (assuming 25% reduction). Laminar flow would need to reduce the incidence of PJI by 35.1% (SD: 9.1) to be a cost-effective strategy.

conclusionThis analysis demonstrates the substantial arthroplasty volume and large reduction in PJI rates required to justify the installation and maintenance costs of this technology. This high cost of implementation should be considered prior to installing laminar flow systems.

Indexed as

Cost effectivenessLaminar flowLaminar flow cost effectivenessLaminar flow efficacySensitivity analysisTotal shoulder arthroplasty

Identifiers

PMID32090144
PMCPMC7007715

What OpenQuestion holds

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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.