| Can we reduce disease burden from osteoarthritis? | |
| | |
MedLine Citation:
|
PMID: 14984357 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The comparison of disparate interventions for the prevention and management of osteoarthritis (OA) is limited by the quality and quantity of published efficacy studies and the use of disparate measures for reporting clinical trial outcomes. The "transfer to utility" technique was used to translate published trial outcomes into a health-related quality-of-life (utility) scale, creating a common metric which supported comparisons between disparate interventions. Total hip replacement (THR) and total knee replacement (TKR) surgery were the most effective treatments and also highly cost-effective, at estimated cost per quality-adjusted life-year (QALY) of 7500 dollars for THR and 10000 dollars for TKR (best estimate). Other apparently highly cost-effective interventions were exercise and strength training for knee OA (< 5000 dollars/QALY), knee bracing, and use of capsaicin or glucosamine sulfate (< 10000 dollars/QALY). The cost per QALY estimates of non-specific and COX-2 inhibitor non-steroidal anti-inflammatory drugs were affected by treatment-related deaths and highly sensitive to the discounting of life-years lost. OA interventions that have been shown to be ineffective (eg, arthroscopy) are targets for redistribution of healthcare resources. OA interventions which lack efficacy studies (eg, prevention programs) require further research to assist priority setting. The application of the Health-sector Wide model to OA demonstrates its role as an evidence-based model that can be successfully applied to identify marginal interventions - those to be expanded and contracted to reduce the expected burden of disease, within current healthcare resources. |
| | |
Authors:
|
Leonie Segal; Susan E Day; Adam B Chapman; Richard H Osborne |
Related Documents
:
|
15864237 - Reducing the costs of phase iii cardiovascular clinical trials. 7159307 - Rural ophthalmology in west africa. 10311667 - Obtaining estimates of marginal cost by drg. 11700777 - Cost effectiveness of bisoprolol in the treatment of chronic congestive heart failure i... 484317 - Siblings as babysitters: responses of adolescents to younger siblings in problem situat... 17236477 - Robotics and virtual reality: a perfect marriage for motor control research and rehabil... |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: The Medical journal of Australia Volume: 180 ISSN: 0025-729X ISO Abbreviation: Med. J. Aust. Publication Date: 2004 Mar |
Date Detail:
|
Created Date: 2004-02-26 Completed Date: 2004-04-06 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0400714 Medline TA: Med J Aust Country: Australia |
Other Details:
|
Languages: eng Pagination: S11-7 Citation Subset: IM |
Affiliation:
|
Health Economics Unit, Faculty of Business and Economics, Monash University, PO Box 477, West Heidelberg, Melbourne, VIC 3081, Australia. Leonie.Segal@buseco.monash.edu.au |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anti-Inflammatory Agents, Non-Steroidal
/
economics,
therapeutic use Australia Braces / economics Cost of Illness* Cost-Benefit Analysis Evidence-Based Medicine / methods Exercise Therapy / economics Humans Models, Theoretical Orthopedic Procedures / economics Osteoarthritis / economics*, therapy* Outcome and Process Assessment (Health Care) Patient Education as Topic / economics Primary Prevention / economics Quality of Life Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Inflammatory Agents, Non-Steroidal |
| Comments/Corrections | |
Comment In:
|
Med J Aust. 2004 Sep 20;181(6):339; author reply 339-40
[PMID:
15377252
]
Med J Aust. 2004 Sep 20;181(6):338; author reply 338-9 [PMID: 15377250 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Epidemiology of osteoarthritis in Australia.
Next Document: Osteoporosis: underrated, underdiagnosed and undertreated.