Evidence map›Paper›PMID 36333993›Full record

Observational studyANZ journal of surgery2022

Surgical plating versus closed reduction for fractures in the distal radius in older patients: a cost-effectiveness analysis from the hospital perspective.

Martin Howell, Andrew Lawson, Justine Naylor, Kirsten Howard, Ian A Harris

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in ANZ journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 35% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Distal radial fractures in adults: 4 versus 6 weeks of cast immobilisation after closed reduction, a randomised controlled trial.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023
    Trial
  5. Article
  6. Review
  7. 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

5 authors at 2 institutions in 1 country.

Martin HowellSchool of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Andrew LawsonWhitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, Australia.ORCID 0000-0002-1367-6443
Justine NaylorWhitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, Australia.
Kirsten HowardSchool of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Ian A HarrisWhitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, Australia.
UNSW Sydney · AUThe University of Sydney · AU

Funding

AO Trauma Asia PacificNational Health and Medical Research Council, 2016 APP1098550The Australian Orthopaedic Association Research FoundationThe Lincoln Foundation
6 · The paper itself

Abstract

backgroundGiven the cost differential between surgical and non-surgical management of distal radius fractures, we aimed to evaluate the cost-effectiveness of surgical compared with non-surgical treatment of distal radius fractures in a cohort of older patients.

methodsThis evaluation was conducted alongside the combined randomized and observational study of surgery for fractures of the distal radius in the elderly (CROSSFIRE) trial (ACTRN 12616000969460) which compared surgical (open reduction and internal fixation using volar-locking plate (VLP) fixation) and non-surgical (closed fracture reduction and cast immobilization (CR)) treatment for displaced distal radius fractures in patients ≥60 years. Cost-effectiveness was assessed from the perspective of the public hospital funder. Hospital records from a sub-sample of participants were used to estimate costs. Outcomes were patient-reported wrist pain and function questionnaire (PRWE) scores and quality adjusted life years (QALYs) calculated using the EuroQoL five-dimension five-level tool (EQ-5D-5L).

resultsFrom 166 participants (81 surgical, 85 non-surgical), costs were obtained for 56 (29 surgical, 27 non-surgical). The mean costs for VLP fixation were Australian dollars (AUD) 6668 (95% CI $4857 to $8479) compared to AUD 3343 (95% CI $1304 to $5381) for CR. The incremental cost-effectiveness ratios (ICER) to achieve a 1-point improvement in the PRWE were AUD 375, AUD 1736 and AUD 1126 at 3, 12 and 24 months for VLP compared with CR. At 12 months, the cost effectiveness was dominated by CR (lower cost and better QoL) whereas at 24 months, the incremental cost per QALY gained by VLP was AUD 1 946 127.

conclusionIn the treatment of distal radius fractures in patients ≥60 years, VLP fixation was not cost-effective compared with CR from the perspective of hospital funders.

Indexed as

Fracture Fixation, InternalRadius FracturesAgedAustraliaBone PlatesCost-Effectiveness AnalysisHospital CostsHumansMiddle AgedObservational Studies as TopicRandomized Controlled Trials as TopicTreatment Outcomeagedbone platesfracture fixationradius fracturesrandomized controlled trial

Identifiers

PMID36333993
PMCPMC10947348
OpenAlexW4308255661

What OpenQuestion holds

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LicenceCC BY-NC
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.