Hospital for Special Surgery, Sports Medicine Institute, New York, New York, U.S.A.
Hospital for Special Surgery, Sports Medicine Institute, New York, New York, U.S.A..
Arthroscopy. 2021 Jun;37(6):2000-2008. doi: 10.1016/j.arthro.2021.01.026. Epub 2021 Jan 27.
To evaluate the quality of orthopaedic cost-effectiveness analyses (CEAs) in accordance with the 2016 recommendations by the Second Panel on Cost-Effectiveness in Health and Medicine.
A systematic review of all CEAs from September 2017 to September 2019 in the 10 highest impact orthopaedic surgery journals was performed. Quality scoring used the Quality of Health Economic Studies (QHES) instrument and the Second Panel checklist. QHES scores ≥80 were considered high quality and <50 poor quality. Mann-Whitney U and independent samples Kruskal-Wallis tests compared individual and multiple groups, respectively. Linear regression analysis was performed to correlate QHES score, checklist item fulfillment, and impact factor.
The 10 highest impact orthopaedic journals published 6,323 articles with 35 (0.55%) meeting inclusion criteria. Total joint arthroplasty (TJA) and sports medicine articles comprised 65.7% of included studies. Overall mean QHES score was 89.0 ± 7.6, with 82.8% considered high quality. Mean proportion of Second Panel checklist items fulfilled was 82.1% ± 13.3%, but no studies performed an impact inventory accounting for consequences within and outside the health care sector or discussed ethical implications. Mean QHES score and satisfied checklist items were significantly different by journal (P = .025 and P = .01, respectively). In addition, there was a moderate positive correlation between QHES score and impact factor (r = 0.446, P = .007). TJA CEAs satisfied a higher number of checklist items compared with spine surgery CEAs.
Recent orthopaedic CEAs have generally been high quality according to updated Second Panel guidelines but consistently miss checklist items relating to societal impact and ethics. TJA and sports medicine continue to be the most frequently studied orthopaedic subspecialties in health economics, and the breadth of orthopaedic procedures analyzed by CEAs has improved.
Level IV, systematic review.
根据 2016 年第二版健康与医学成本效益panel 的建议，评估骨科成本效益分析（CEA）的质量。
对 2017 年 9 月至 2019 年 9 月在 10 种最具影响力的骨科手术期刊上发表的所有 CEA 进行了系统回顾。质量评分使用卫生经济学研究质量（QHES）工具和第二版 panel 清单。QHES 得分≥80 分为高质量，<50 分为低质量。Mann-Whitney U 和独立样本 Kruskal-Wallis 检验分别比较了个体和多个组。进行线性回归分析以关联 QHES 评分、清单项目完成情况和影响因素。
10 种最具影响力的骨科期刊发表了 6323 篇文章，其中 35 篇（0.55%）符合纳入标准。全关节置换术（TJA）和运动医学文章占纳入研究的 65.7%。总体平均 QHES 得分为 89.0±7.6，82.8%被认为是高质量的。第二版清单项目完成比例的平均为 82.1%±13.3%，但没有研究进行影响库存核算，以考虑医疗保健部门内外的后果或讨论道德影响。期刊之间的 QHES 评分和满足清单项目的平均差异有统计学意义（P=0.025 和 P=0.01，分别）。此外，QHES 评分与影响因素之间存在中度正相关（r=0.446，P=0.007）。TJA CEA 比脊柱手术 CEA 满足更多的清单项目。
根据更新的第二版 panel 指南，最近的骨科 CEA 通常质量较高，但始终遗漏与社会影响和伦理学相关的清单项目。TJA 和运动医学仍然是健康经济学中研究最多的骨科亚专科，CEA 分析的骨科手术范围有所扩大。
IV 级，系统评价。
