Leonenko Vasiliy N, Kaliberda Yulia E, Muravyova Yulia V, Artyukh Vasiliy A
Faculty of Digital Transformation, ITMO University, Kronverksky Pr. 49A, 197101 St. Petersburg, Russia.
Russian Scientific Research Institute of Traumatology and Orthopedics Named after R.R. Vreden, Akademika Baykova st, 8, 195427 St. Petersburg, Russia.
J Pers Med. 2022 Jul 26;12(8):1216. doi: 10.3390/jpm12081216.
Today, periprosthetic joint infection (PJI) is one of the leading indications for revision surgery and the most ominous complication in artificial joint patients. The current state of the art for treating PJI requires the development of methods for planning the costs at different scales to facilitate the selection of the best treatment methods. In this paper, we perform a cost-effectiveness assessment for strategies related to the treatment of PJI using a composite decision support modeling framework. Within the framework, two models are implemented: a detailed discrete-event probabilistic model based on the decision tree approach and a dynamic Markov model with generalized states. The application of the framework is demonstrated on the dataset which was provided by the Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden. The analyzed dataset contains 600 patient records divided into two groups (retrospective group, based on old records, and prospective group, based on real-time follow-up). The cost-effectiveness of treatment methods was compared based on associated costs and QALY units gained, with the mentioned two indicators calculated using two models independently from each other. As a result, two comparative rankings of cost-effectiveness of PJI treatment methods were presented based on the model output.
如今，人工关节周围感染（PJI）是翻修手术的主要指征之一，也是人工关节患者最严重的并发症。目前治疗PJI的先进方法需要开发不同规模成本规划的方法，以促进最佳治疗方法的选择。在本文中，我们使用复合决策支持建模框架对与PJI治疗相关的策略进行成本效益评估。在该框架内，实现了两个模型：一个基于决策树方法的详细离散事件概率模型和一个具有广义状态的动态马尔可夫模型。该框架的应用在以R.R.弗列登命名的俄罗斯创伤与矫形科学研究院提供的数据集上得到了验证。分析的数据集包含600份患者记录，分为两组（基于旧记录的回顾性组和基于实时随访的前瞻性组）。基于相关成本和获得的质量调整生命年（QALY）单位比较治疗方法的成本效益，上述两个指标使用两个相互独立的模型进行计算。结果，基于模型输出给出了PJI治疗方法成本效益的两个比较排名。
