Evidence map›Paper›PMID 36372813›Full record

Trial reportEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023

Cost-effectiveness of on-demand removal of syndesmotic screws.

D Penning, F R K Sanders, S van Dieren, G R Roukema, J Vermeulen, J Winkelhagen, J C Goslings, T Schepers, RODEO collaborator group

Abstract readRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. 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. Review
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

9 authors.

D Penning *Amsterdam UMC Location University of Amsterdam, Trauma Unit , Room J1A-214, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0003-1355-1322
F R K Sanders *Amsterdam UMC Location University of Amsterdam, Trauma Unit , Room J1A-214, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-5479-418X
S van DierenDepartment of Epidemiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-3084-0495
G R RoukemaSurgery Department, Maasstad Hospital, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0002-8414-8808
J VermeulenDepartment of Surgery, Spaarne Hospital, Hoofddorp, The Netherlands.
J WinkelhagenDepartment of Surgery, Dijklander Hospital, Hoorn, The Netherlands.ORCID http://orcid.org/0000-0001-8658-3953
J C GoslingsDepartment of Surgery, OLVG, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0003-3942-0304
T SchepersAmsterdam UMC Location University of Amsterdam, Trauma Unit , Room J1A-214, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. t.schepers@amsterdamumc.nl.ORCID http://orcid.org/0000-0003-1172-4939
RODEO collaborator group

Funding

ZonMw 843002705
6 · The paper itself

Abstract

purposeSyndesmotic screw removal following acute syndesmotic injury is a commonly performed procedure. However, recent studies suggest that the removal does not result in improved patient reported outcome, while the procedure has proved not to be without complications. The aim of this study was to present a health-economic evaluation of on-demand removal (ODR) compared to routine removal (RR) of the syndesmotic screw.

methodsData were collected from the RODEO trial, a randomized controlled non-inferiority trial comparing functional outcome of ODR with RR. Economic evaluation resulted in total costs, costs (in Euro) per quality adjusted life year (QALY) and costs per point improvement on the Olerud Molander Ankle Score (OMAS). This included both direct and indirect costs.

resultsTotal costs for ODR were significantly lower with a mean difference of 3160 euro compared to RR (p < 0.001). The difference in QALY was not significant. The difference in OMAS at 12 months was 1.79 with an incremental cost-effectiveness ratio (ICER) of €-1763 (p = 0.512). The ICER was well below the willingness to pay. Although unit costs might vary between hospitals and countries, these results provide relevant data of cost-effectiveness.

conclusionThe clinical effectiveness of both ODR and RR can be considered equal. The costs are lower for patients treated with ODR, which leads to the conclusion that ODR is cost-effective.

Indexed as

Ankle InjuriesFracture Fixation, InternalBone ScrewsCost-Benefit AnalysisDevice RemovalHumansTreatment OutcomeAnkle fractures surgeryCost–Benefit analysisFracture fixation, internal/economicsFracture fixation, internal/instrumentationImplant removalQuality of life

Identifiers

PMID36372813
PMCPMC10175308

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.