Cost-Effectiveness Analyses in Orthopaedic Sports Medicine

Abstract

The CEA literature in sports medicine is good; however, there is a paucity of studies, and the available evidence is focused on a few procedures. More work needs to be conducted to quantify the cost-effectiveness of different techniques and procedures within sports medicine. The QHES tool may be useful for the evaluation of future CEAs.

What Are the Strength of Recommendations and Methodologic Reporting in Health Economic Studies in Orthopaedic Surgery?

“…When examining the studies with the validated QHES instrument, we found similarly mixed reporting, with a mean score of 79.7, and mean adherence rates for specific parameters ranging from 41% (explicit discussion of biases) to 100% (conclusions based on study results). These results are similar to those reported in a review of orthopaedic sports literature (mean of 81.8) [14]. When analyzed by strength of recommendations, there appear to be few differences in reporting practices.…”

“…Given the importance of cost-effectiveness research in clinical decision and policy-making, understanding the proportions of strong and weak recommendations offered by these studies is imperative. This is especially true given the steadily increasing volume of such studies in the orthopaedic literature [3][4][5]14] and seen again in our study. This approach enables an understanding of the proportion of cost-effectiveness analysis studies that are either lacking in or have uncertainty around key data parameters, which limits the strength of the authors' recommendations.…”

“…One possible explanation for this improvement could be the more recent study period in our analysis. Prior reviews have shown a tendency toward improvements in reporting with time [11,14]. Furthermore, studies focused on only one intervention were excluded from our study, which could explain the increased adherence to framing practices seen in our study.…”

“…Finally, results reporting included whether a sensitivity analysis was performed. In addition to these parameters which have been studied previously [5], studies were evaluated using The Quality of Health Economic Studies (QHES) instrument [15], a 16-item checklist with defined point values for each that sum to 100, which has been validated to evaluate the quality of health economics research [6] and has been used in the orthopaedic literature [14]. All analyses of included studies were performed independently by two of the authors (ECM, MES), with any discrepancies being reconciled with mutual agreement following discussion between the two authors.…”

Moving Toward Clinic-Based Motion Analysis: Kinect® Camera as an Example

“…1,2 Currently, assessment tools such as the Landing Error Scoring System (LESS) have been described in the literature and adopted by clinicians as valuable tools used to assess knee injury risk. 3 Unfortunately, while these tools have been shown to be valid, they rely on subjective criteria to assess patient performance, which may be affected by clinician experience.…”