Abstract
Background: The current study reviews the literature on the cost-effectiveness of conventional diskectomy compared to other surgical techniques, by assessing studies
with economical evaluation and studies using proxy measures of cost-effectiveness.
Methods: In April 2016, a comprehensive search was conducted in Medline, Embase and the Cochrane Database. Reference lists of retrieved articles were perused
for further relevant publications. Randomized controlled trials and comparison studies, comparing conventional diskectomy to other surgical interventions for
patients with lumbar disk herniation, were included and reviewed by the authors. Data were gathered on the methodology of the studies, including study design,
randomization, follow-up period, cost-estimation, etc. and the quality of the published studies was quantified using a modified version of the Drummond checklist.
Results: Twenty-four articles were included in the review, 9 retrieved from the original search, and an additional 15 from reference lists. Four studies included an
economical evaluation and 20 reported proxy measures of cost-effectiveness. The quality of studies varied considerably and results were ambiguous; the four economic
studies favored conventional diskectomy, but none were randomized trials. Of the twenty proxy studies some favored the alternatives, and some reported no clear
difference.
Conclusions: The available literature does not allow for strong conclusions due to the sparsity of high quality economic studies. The available evidence, however,
suggests that any cost-effectiveness difference between conventional diskectomy and the alternatives is unlikely to be great.
with economical evaluation and studies using proxy measures of cost-effectiveness.
Methods: In April 2016, a comprehensive search was conducted in Medline, Embase and the Cochrane Database. Reference lists of retrieved articles were perused
for further relevant publications. Randomized controlled trials and comparison studies, comparing conventional diskectomy to other surgical interventions for
patients with lumbar disk herniation, were included and reviewed by the authors. Data were gathered on the methodology of the studies, including study design,
randomization, follow-up period, cost-estimation, etc. and the quality of the published studies was quantified using a modified version of the Drummond checklist.
Results: Twenty-four articles were included in the review, 9 retrieved from the original search, and an additional 15 from reference lists. Four studies included an
economical evaluation and 20 reported proxy measures of cost-effectiveness. The quality of studies varied considerably and results were ambiguous; the four economic
studies favored conventional diskectomy, but none were randomized trials. Of the twenty proxy studies some favored the alternatives, and some reported no clear
difference.
Conclusions: The available literature does not allow for strong conclusions due to the sparsity of high quality economic studies. The available evidence, however,
suggests that any cost-effectiveness difference between conventional diskectomy and the alternatives is unlikely to be great.
| Original language | English |
|---|---|
| Journal | Rheumatology and Orthopedic Medicine |
| Volume | 3 |
| Issue number | 2 |
| Pages (from-to) | 1-8 |
| DOIs | |
| Publication status | Published - Jan 2018 |