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Cost-utility analysis of cemented hemiarthroplasty versus hydroxyapatite-coated uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures
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WHiTE 5 trial collaborators (Including: Png, May E., Petrou, Stavros, Fernandez, Miguel A., Achten, Juul, Parsons, Nicholas R., McGibbon, Alwin, Gould, Jenny, Griffin, Xavier L. and Costa, Matthew L.). (2022) Cost-utility analysis of cemented hemiarthroplasty versus hydroxyapatite-coated uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures. The Bone & Joint Journal, 104-B (8). pp. 922-928. doi:10.1302/0301-620x.104b8.bjj-2022-0417.r1 ISSN 2049-4394.
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Official URL: https://doi.org/10.1302/0301-620x.104b8.bjj-2022-0...
Abstract
Aims The aim of this study was to compare the cost-effectiveness of cemented hemiarthroplasty (HA) versus hydroxyapatite-coated uncemented HA for the treatment of displaced intracapsular hip fractures in older adults. Methods A within-trial economic evaluation was conducted based on data collected from the World Hip Trauma Evaluation 5 (WHiTE 5) multicentre randomized controlled trial in the UK. Resource use was measured over 12 months post-randomization using trial case report forms and participant-completed questionnaires. Cost-effectiveness was reported in terms of incremental cost per quality-adjusted life year (QALY) gained from the NHS and personal social service perspective. Methodological uncertainty was addressed using sensitivity analysis, while decision uncertainty was represented graphically using confidence ellipses and cost-effectiveness acceptability curves. Results The base-case analysis showed that cemented implants were cost-saving (mean cost difference -£961 (95% confidence interval (CI) -£2,292 to £370)) and increased QALYs (mean QALY difference 0.010 (95% CI 0.002 to 0.017)) when compared to uncemented implants. The probability of the cemented implant being cost-effective approximated between 95% and 97% at alternative cost-effectiveness thresholds held by decision-makers, and its net monetary benefit was positive. The findings remained robust against all the pre-planned sensitivity analyses. Conclusion This study shows that cemented HA is cost-effective compared with hydroxyapatite-coated uncemented HA in older adults with displaced intracapsular hip fractures. Cite this article: Bone Joint J 2022;104-B(8):922–928.
Item Type: | Journal Article | ||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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SWORD Depositor: | Library Publications Router | ||||||
Journal or Publication Title: | The Bone & Joint Journal | ||||||
Publisher: | British Editorial Society of Bone and Joint Surgery | ||||||
ISSN: | 2049-4394 | ||||||
Official Date: | 1 August 2022 | ||||||
Dates: |
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Volume: | 104-B | ||||||
Number: | 8 | ||||||
Page Range: | pp. 922-928 | ||||||
DOI: | 10.1302/0301-620x.104b8.bjj-2022-0417.r1 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Copyright Holders: | © 2022 The British Editorial Society of Bone & Joint Surgery |
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