Evidence map›Paper›PMID 34296707›Full record

Observational studyCanadian journal of surgery. Journal canadien de chirurgie2021

Lifetime incremental cost-utility ratios for minimally invasive surgery for degenerative lumbar spondylolisthesis relative to failed medical management compared with total hip and knee arthroplasty for osteoarthritis.

Eric J Crawford, Robert A Ravinsky, Peter C Coyte, Y Raja Rampersaud

Open access · diamondAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Canadian journal of surgery. Journal canadien de chirurgie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 15% of its field
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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Observational
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 at 2 institutions in 2 countries.

Eric J CrawfordFrom the Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Crawford, Rampersaud); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Crawford, Coyte); the Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Ariz. (Ravinksy); the Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud); the Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud); and the Spinal Program, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud).
Robert A RavinskyFrom the Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Crawford, Rampersaud); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Crawford, Coyte); the Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Ariz. (Ravinksy); the Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud); the Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud); and the Spinal Program, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud).
Peter C CoyteFrom the Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Crawford, Rampersaud); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Crawford, Coyte); the Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Ariz. (Ravinksy); the Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud); the Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud); and the Spinal Program, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud).
Y Raja RampersaudFrom the Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Crawford, Rampersaud); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Crawford, Coyte); the Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, Ariz. (Ravinksy); the Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud); the Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud); and the Spinal Program, Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ont. (Rampersaud).
University of Arizona · USUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The objective of this study was to compare the cost-effectiveness of minimally invasive surgery (MIS) for patients with degenerative lumbar spondylolisthesis (DLS) relative to failed medical management with the cost-effectiveness of hip and knee arthroplasty for matched cohorts of patients with osteoarthritis. Methods: A cohort of patients with DLS undergoing MIS procedures with decompression alone or decompression and instrumented fusion between 2008 and 2014 was matched to cohorts of patients with hip osteoarthritis (OA) and knee OA undergoing total joint replacement. Incremental cost-utility ratios (ICURs) were calculated from the perspective of the Ontario Ministry of Health, using prospectively collected Short Form-6 Dimension utility data. Costs and quality-adjusted life years (QALYs) were discounted at 3% and sensitivity analyses were performed. Results: Sixty-six patients met the inclusion criteria for the DLS cohort (n = 35 for decompression alone), with a minimum follow-up time of 1 year (mean 1.7 yr). The mean age of patients in the DLS cohort was 64.76 years, and 45 patients (68.2%) were female. For each cohort, utility scores improved from baseline to follow-up and the magnitude of the gain did not differ by group. Lifetime ICURs comparing surgical with nonsurgical care were Can$7946/QALY, Can$7104/QALY and Can$5098/QALY for the DLS, knee OA and hip OA cohorts, respectively. Subgroup analysis yielded an increased ICUR for the patients with DLS who underwent decompression and fusion (Can$9870/QALY) compared with that for the patients with DLS who underwent decompression alone (Can$5045/QALY). The rank order of the ICURs by group did not change with deterministic or probabilistic sensitivity analyses. Conclusion: Lifetime ICURs for MIS procedures for DLS are similar to those for total joint replacement. Future research should adopt a societal perspective and potentially capture further economic benefits of MIS procedures.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeCanadaCohort StudiesCost-Benefit AnalysisDecompression, SurgicalFemaleHumansLumbar VertebraeMaleMiddle AgedMinimally Invasive Surgical ProceduresOsteoarthritis, HipOsteoarthritis, KneeQuality-Adjusted Life YearsSpinal Fusion

Identifiers

PMID34296707
PMCPMC8410474
OpenAlexW3186536111

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.