ArticleBrain & spine2025
Cost-Utility Analysis of a pre-, peri- and postoperative rehabilitation pathway versus usual care in patients undergoing lumbar fusion surgery.
Article in Brain & spine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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.
Who cites it
2 citing papers in PubMed.
- Return on Investment of the Back At Work After Surgery (BAAS) Care Pathway Compared to Care-as-Usual in Knee Arthroplasty.Journal of occupational rehabilitation · 2025Observational
- The Infinity Loop of Healthcare Innovation: Development of an Integrated Rehabilitation Pathway for Lumbar Fusion Surgery Through Design Thinking.International journal of integrated careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: The REACT trial demonstrated that a pre-, peri- and postoperative rehabilitation pathway (i.e. REACT rehabilitation) was associated with greater improvements in disability, back pain, and return-to-work rate, compared with usual care, after lumbar fusion surgery (LFS). Research question: To assess the potential cost-utility of the REACT rehabilitation relative to usual care in patients undergoing LFS for degenerative conditions. Materials and methods: A cost-utility analysis over a six-month time horizon was conducted using data from the REACT trial from the perspective of the Belgian healthcare system. A secondary analysis from a societal perspective included indirect costs associated with productivity losses. Probabilistic sensitivity analysis evaluated uncertainty. Primary outcomes were differences in costs, quality-adjusted life years (QALY), and incremental cost-effectiveness ratio (ICER). Results: The main analysis included 72 patients (mean age 55.1 years [SD 14.1], 59.7% female). The REACT rehabilitation reduced outpatient medical costs (p < 0.0001) and indirect costs (p < 0.0001), with a trend toward lower hospitalization costs (p = 0.07), despite higher rehabilitation costs (p = 0.002). There was no significant QALY improvement. The resulting ICER of -87,762.78€/QALY indicated that REACT rehabilitation was more effective and less costly than usual care. Probabilistic sensitivity analysis revealed a high probability of being cost-effective (92.8%).Secondary analysis confirmed the cost-utility of REACT rehabilitation when including indirect costs. Discussion and conclusion: In this cost-utility analysis, the REACT rehabilitation was cost-effective compared to usual care for patients undergoing LFS. Although the REACT rehabilitation did not significantly enhance QALY or decrease total direct costs, it significantly reduced indirect costs, which outweighed direct costs in patients undergoing LFS.
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Registered trials
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.