Evidence map›Paper›PMID 37802609›Full record

ArticleBMJ open2023

Cost-effectiveness of decellularised bone allograft compared with fresh-frozen bone allograft for acetabular impaction bone grafting during a revision hip arthroplasty in the UK.

Kern Cowell, Patrick Statham, Gurdeep Singh Sagoo, James H Chandler, Anthony Herbert, Paul Rooney, Ruth K Wilcox, Hazel L Fermor

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 29% 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

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Review
  2. 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 2 institutions in 1 country.

Kern CowellInstitute of Medical and Biological Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, UK.ORCID 0000-0003-1737-0836
Patrick StathamInstitute of Medical and Biological Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, UK.
Gurdeep Singh SagooAcademic Unit of Health Economics, University of Leeds, Leeds, UK.ORCID 0000-0003-1427-1437
James H ChandlerInstitute of Design, Robotics and Optimisation, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, UK.
Anthony HerbertInstitute of Medical and Biological Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, UK.
Paul RooneyResearch and Development, NHS Blood and Transplant Tissue and Eye Services, Speke, UK.
Ruth K WilcoxInstitute of Medical and Biological Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, UK.
Hazel L FermorInstitute of Medical and Biological Eningeering, School of Biomedical Sciences, University of Leeds, Leeds, UK h.l.fermor@leeds.ac.uk.
University of Leeds · GBNHS Blood and Transplant · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesFresh-frozen allograft is the gold-standard bone graft material used during revision hip arthroplasty. However, new technology has been developed to manufacture decellularised bone with potentially better graft incorporation. As these grafts cost more to manufacture, the aim of this cost-effectiveness study was to estimate whether the potential health benefit of decellularised bone allograft outweighs their increased cost. STUDY

designA Markov model was constructed to estimate the costs and the quality-adjusted life years of impaction bone grafting during a revision hip arthroplasty.

settingThis study took the perspective of the National Health Service in the UK.

participantsThe Markov model includes patients undergoing a revision hip arthroplasty in the UK.

interventionImpaction bone grafting during a revision hip arthroplasty using either decellularised bone allograft or fresh-frozen allograft. MEASURES: Outcome measures included: total costs and quality-adjusted life years of both interventions over the lifetime of the model; and incremental cost-effectiveness ratios for both graft types, using base case parameters, univariate sensitivity analysis and probabilistic analysis.

resultsThe incremental cost-effectiveness ratio for the base case model was found to be £270 059 per quality-adjusted life year. Univariate sensitivity analysis found that changing the discount rate, the decellularised bone graft cost, age of the patient cohort and the revision rate all had a significant effect on the incremental cost-effectiveness ratio.

conclusionsAs there are no clinical studies of impaction bone grafting using a decellularised bone allograft, there is a high level of uncertainty around the costs of producing a decellularised bone allograft and the potential health benefits. However, if a decellularised bone graft was manufactured for £2887 and lowered the re-revision rate to less than 64 cases per year per 10 000 revision patients, then it would most likely be cost-effective compared with fresh-frozen allograft.

Indexed as

Arthroplasty, Replacement, HipHip ProsthesisAcetabulumAllograftsBone TransplantationCost-Benefit AnalysisFollow-Up StudiesHumansProsthesis FailureReoperationState MedicineTreatment OutcomeUnited KingdomBone diseasesHEALTH ECONOMICSHipOrthopaedic & trauma surgery

Identifiers

PMID37802609
PMCPMC10565200
OpenAlexW4387440082

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.