Functional outcome and cost-effectiveness of pulsed electromagnetic fields in the treatment of acute scaphoid fractures: a cost-utility analysis

Autor: Peter R. Brink, Koen Dullaert, Judith P. M. Schots, Brigitte A. B. Essers, Martijn Poeze, Pascal F. W. Hannemann
Přispěvatelé: Surgery, MUMC+: KIO Kemta (9), RS: CAPHRI School for Public Health and Primary Care, RS: NUTRIM - R2 - Gut-liver homeostasis, RS: CAPHRI - R2 - Creating Value-Based Health Care
Jazyk: angličtina
Rok vydání: 2015
Předmět:
STIMULATION
Male
Cost effectiveness
medicine.medical_treatment
Cost-Benefit Analysis
MULTICENTER
DOUBLE-BLIND
Fractures
Bone
SCREW
Surveys and Questionnaires
Orthopedics and Sports Medicine
FIXATION
health care economics and organizations
ULTRASOUND
Netherlands
Bone growth
Acute fractures
Cost-effectiveness analysis
Functional outcome
Middle Aged
Treatment Outcome
Scaphoid bone
Female
Quality-Adjusted Life Years
Research Article
Adult
medicine.medical_specialty
Adolescent
Pulsed electromagnetic fields
UNION
Young Adult
Electromagnetic Fields
Rheumatology
Double-Blind Method
Scaphoid
medicine
Humans
COMPUTED-TOMOGRAPHY
Reduction (orthopedic surgery)
Aged
Scaphoid Bone
Cost–utility analysis
business.industry
Cost-utility analysis
RANDOMIZED-TRIAL
Quality-adjusted life year
Economic evaluation
Physical therapy
business
Zdroj: BMC Musculoskeletal Disorders
BMC Musculoskeletal Disorders, 16:84. BioMed Central Ltd
ISSN: 1471-2474
Popis: Background Physical forces have been widely used to stimulate bone growth in fracture repair. Addition of bone growth stimulation to the conservative treatment regime is more costly than standard health care. However, it might lead to cost-savings due to a reduction of the total amount of working days lost. This economic evaluation was performed to assess the cost-effectiveness of Pulsed Electromagnetic Fields (PEMF) compared to standard health care in the treatment of acute scaphoid fractures. Methods An economic evaluation was carried out from a societal perspective, alongside a double-blind, randomized, placebo-controlled, multicenter trial involving five centres in the Netherlands. One hundred and two patients with a clinically and radiographically proven fracture of the scaphoid were included in the study and randomly allocated to either active bone growth stimulation or standard health care, using a placebo. All costs (medical costs and costs due to productivity loss) were measured during one year follow up. Functional outcome and general health related quality of life were assessed by the EuroQol-5D and PRWHE (patient rated wrist and hand evaluation) questionnaires. Utility scores were derived from the EuroQol-5D. Results The average total number of working days lost was lower in the active PEMF group (9.82 days) compared to the placebo group (12.91 days) (p = 0.651). Total medical costs of the intervention group (€1594) were significantly higher compared to the standard health care (€875). The total amount of mean QALY’s (quality-adjusted life year) for the active PEMF group was 0.84 and 0.85 for the control group. The cost-effectiveness plane shows that the majority of all cost-effectiveness ratios fall into the quadrant where PEMF is not only less effective in terms of QALY’s but also more costly. Conclusion This study demonstrates that the desired effects in terms of cost-effectiveness are not met. When comparing the effects of PEMF to standard health care in terms of QALY’s, PEMF cannot be considered a cost-effective treatment for acute fractures of the scaphoid bone. Trial registration Netherlands Trial Register (NTR): NTR2064
Databáze: OpenAIRE
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