Economic evaluations in fracture research an introduction with examples of foot fractures

Abstract

Introduction:The incidence of foot fractures is increasing. These types of fractures represent the most expensive group of diagnoses in the emergency department. Next to this, the need for economic evaluation studies is growing fast. The aim of this article is to provide healthcare professionals with an introduction to economic evaluation studies in the field of foot fractures. Types of economic evaluation studies: Four types of economic evaluation studies exist: cost-minimization analysis (CMA), cost-benefit analysis (CBA), cost-effectiveness analysis (CEA), and cost-utility analysis (CUA). An economic evaluation study can be either trial-or model-based. Cost Assessment: When assessing costs in an economic evaluation study, three steps need to be made: identification of costs, measurement of costs, and valuation of costs. Perspective of analysis: Two main perspectives exist in economic evaluation studies. When using a healthcare perspective, only the potential costs and benefits of an intervention for the healthcare sector are included. The societal perspective includes all potential costs, including societal costs. Synthesis of costs and effects and uncertainty analysis:The level of cost-effectiveness can be objectively expressed using the incremental cost-effectiveness ratio (ICER). This measure can be plotted in a costeffectiveness plane and can be compared with existing regional ceiling ratios. Conclusion: Although this article is not a guideline for economic evaluations, we do want to present five tips to consider when performing an economic evaluation. Firstly, when measuring resource use, consult the Database of Instruments for Resource Use Measurements (DIRUM) to find an appropriate instrument. Secondly, when measuring utility values, use the EuroQol questionnaire if possible. Thirdly, when setting up an economic evaluation study, consult the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) database for the appropriate pharmacoeconomic guidelines. Fourthly, consult international guidelines to decide which study design is most appropriate. Finally, when performing an economic evaluation, consult a heath technology assessment (HTA) specialist from the start to ensure methodological quality.

The Societal Burden associated with Adolescent Idiopathic Scoliosis: a cross-sectional burden-of-disease study

“…This cross-sectional, prevalence-based, bottom-up approach cost-of-illness study adopted a societal perspective. The cross-sectional nature of the study implied that measurements were done at one point in time 15 . Prevalence-based studies consider the costs attributable to the total number of cases in a set time frame (usually a year).…”

“…A bottom-up costing approach was used whereby cost estimation was made using three steps: (1) identi cation, (2) measurement and (3) valuation, to estimate the associated costs with AIS 15,22 .…”

“…Generic questionnaires allow for comparison of outcomes across populations and interventions since they are not disease-speci c but rather adopt a more general perspective 30 . The EQ-5D-5L is commonly used and recommended for economic evaluation 15,17 . It consists of ve domains each consisting of one question:…”

“…The normality assumption is usually violated for the cost data, therefore non-parametric bootstrapping was performed (1000 replications) per cost category 15 . An alpha level was set at 0.05 for all cost analyses.…”

The economic and societal burden associated with adolescent idiopathic scoliosis: A burden-of-disease study protocol

“…This cross-sectional, prevalence-based, bottom-up approach burden of disease study will adopt a societal perspective. Cross-sectional nature of the study implies that measurements will be done at one point in time [17] . Prevalence-based studies consider the costs attributable to the total number of cases in a set time frame (usually a year).…”