Evidence map›Paper›PMID 35658671›Full record

ArticleBone & joint open2022

Cost-utility analysis of cast compared to removable brace in the management of adult patients with ankle fractures.

Henry Nwankwo, James Mason, Matthew L Costa, Nicholas Parsons, Anthony Redmond, Helen Parsons, Aminul Haque, Rebecca S Kearney

Open access · goldAbstract read
In one paragraph

Article in Bone & joint open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
1.1field-weighted citation impact, top 14% 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

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Rehabilitation for ankle fractures in adults.The Cochrane database of systematic reviews · 2024
    Pooled it
  3. 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

8 authors at 3 institutions in 1 country.

Henry NwankwoWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.ORCID 0000-0001-7401-1923
James MasonWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
Matthew L CostaOxford Trauma and Emergency Care, Nuffield Department of Rheumatology, Musculoskeletal and Orthopaedic Sciences, University of Oxford, Oxford, UK.
Nicholas ParsonsWarwick Medical School, University of Warwick, Coventry, UK.
Anthony RedmondLeeds Institute for Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
Helen ParsonsWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
Aminul HaqueWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
Rebecca S KearneyWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
University Hospital Coventry · GBNuffield Orthopaedic Centre · GBUniversity of Leeds · GB

Funding

Wellcome Trust
6 · The paper itself

Abstract

aimsTo compare the cost-utility of removable brace compared with cast in the management of adult patients with ankle fracture.

methodsA within-trial economic evaluation conducted from the UK NHS and personnel social services (PSS) perspective. Health resources and quality-of-life data were collected as part of the Ankle Injury Rehabilitation (AIR) multicentre, randomized controlled trial over a 12-month period using trial case report forms and patient-completed questionnaires. Cost-utility analysis was estimated in terms of the incremental cost per quality adjusted life year (QALY) gained. Estimate uncertainty was explored by bootstrapping, visualized on the incremental cost-effectiveness ratio plane. Net monetary benefit and probability of cost-effectiveness were evaluated at a range of willingness-to-pay thresholds and visualized graphically.

resultsThe incremental cost and QALYs of using brace over a 12-month period were £46.73 (95% confidence interval (CI) £-9 to £147) and 0.0141 (95% CI -0.005 to 0.033), respectively. The cost per QALY gained was £3,318. The probability of brace being cost-effective at a £30,000 per QALY willingness-to-pay threshold was 88%. The results remained robust to a range of sensitivity analyses.

conclusionThis within-trial economic evaluation found that it is probable that using a removable brace provides good value to the NHS when compared to cast, in the management of adults with ankle fracture. Cite this article:

Indexed as

Achilles tendon ruptureankle fractureAnkle Injurycastcost-utility analysisdeep vein thrombosisEQ-5DEQ-5D-5Lfracture of the ankleimmobilizationrandomized controlled trialstandard deviationStudent T-test

Identifiers

PMID35658671
PMCPMC9233419
OpenAlexW4281684057

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.