Zanghelini Fernando, Ponzo Aisling, Xydopoulos Georgios, Fordham Richard, Khanal Saval
Health Economics Consulting, Norwich Medical School, University of East Anglia, Norwich NR4 7UQ, UK.
Geriatrics (Basel). 2024 Oct 5;9(5):129. doi: 10.3390/geriatrics9050129.
GaitSmart (GS) is a sensor-based digital medical device that can be used with the integrated app vGym to provide a personalised rehabilitation programme for older people undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). This study aimed to determine whether the GS intervention used in the rehabilitation of older people undergoing THA or TKA is potentially cost-effective compared to the current standard of care (SoC).
Decision-analytic modelling was conducted to estimate the cost-effectiveness over a seventeen-week time horizon from an NHS perspective. UK clinical and cost data from the GaitSmart randomised clinical trial was used to obtain the input parameters, and a sensitivity analysis was performed to address uncertainties.
Over a seventeen-week time horizon, GS incurred cost savings of GBP 450.56 and a 0.02 gain in quality-adjusted life years (QALYs) compared to the SoC. These results indicate that GS is the dominant intervention because the device demonstrated greater effectiveness and lower costs. Probabilistic sensitivity analyses confirm the robustness of our results.
GS appears to offer short-term efficiency benefits and demonstrates cost-effectiveness for the improvement in gait in people undergoing THA or TKA, compared to the SoC.
GaitSmart(GS)是一种基于传感器的数字医疗设备,可与集成应用程序vGym配合使用,为接受全髋关节置换术(THA)或全膝关节置换术(TKA)的老年人提供个性化康复方案。本研究旨在确定与当前标准护理(SoC)相比,GS干预措施用于接受THA或TKA的老年人康复是否具有潜在成本效益。
从英国国家医疗服务体系(NHS)的角度,进行决策分析建模以估计17周时间范围内的成本效益。使用来自GaitSmart随机临床试验的英国临床和成本数据来获取输入参数,并进行敏感性分析以解决不确定性。
在17周的时间范围内,与SoC相比,GS节省了450.56英镑的成本,质量调整生命年(QALY)增加了0.02。这些结果表明GS是主要干预措施,因为该设备显示出更高的有效性和更低的成本。概率敏感性分析证实了我们结果的稳健性。
与SoC相比,GS似乎提供了短期效率优势,并证明了在接受THA或TKA的人群中改善步态的成本效益。