Nwankwo, H, Mason, J, Costa, ML et al. (5 more authors) (2022) Cost-utility analysis of cast compared to removable brace in the management of adult patients with ankle fractures. Bone & Joint Open, 3 (6). pp. 455-462. ISSN 2633-1462
Abstract
Aims
To compare the cost-utility of removable brace compared with cast in the management of adult patients with ankle fracture.
Methods
A 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.
Results
The 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.
Conclusion
This 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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 Author(s) et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/ |
Keywords: | cost-utility analysis; ankle fracture; cast; fracture of the ankle; randomized controlled trial; Ankle Injury; immobilization; EQ-5D-5L; Student T-test; EQ-5D; standard deviation; Achilles tendon rupture; deep vein thrombosis |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Clinical Biomechanic & Physical Med (LIRMM) (Leeds) |
Funding Information: | Funder Grant number NIHR National Inst Health Research NF-SI-0616-10108 |
Depositing User: | Symplectic Publications |
Date Deposited: | 19 Jan 2023 12:00 |
Last Modified: | 19 Jan 2023 12:00 |
Status: | Published |
Publisher: | The British Editorial Society of Bone & Joint Surgery |
Identification Number: | 10.1302/2633-1462.36.bjo-2022-0036 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:195290 |