The 2-Year Cost-Effectiveness of 3 options to Treat Lumbar Spinal Stenosis Patients.
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| Title: | The 2-Year Cost-Effectiveness of 3 options to Treat Lumbar Spinal Stenosis Patients. |
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| Authors: | Udeh, Belinda L., Costandi, Shrif, Dalton, Jarrod E., Ghosh, Raktim, Yousef, Hani, Mekhail, Nagy |
| Source: | Pain Practice. Feb2015, Vol. 15 Issue 2, p107-116. 10p. |
| Subjects: | Economic impact, Medicare, Spinal stenosis treatment, Cost effectiveness, Lumbar vertebrae, Research funding, Quality-adjusted life years, Data analysis software, Descriptive statistics |
| Abstract: | Lumbar spinal stenosis ( LSS) may result from degenerative changes of the spine, which lead to neural ischemia, neurogenic claudication, and a significant decrease in quality of life. Treatments for LSS range from conservative management including epidural steroid injections ( ESI) to laminectomy surgery. Treatments vary greatly in cost and success. ESI is the least costly treatment may be successful for early stages of LSS but often must be repeated frequently. Laminectomy surgery is more costly and has higher complication rates. Minimally invasive lumbar decompression ( mild ® ) is an alternative. Using a decision-analytic model from the Medicare perspective, a cost-effectiveness analysis was performed comparing mild ® to ESI or laminectomy surgery. The analysis population included patients with LSS who have moderate to severe symptoms and have failed conservative therapy. Costs included initial procedure, complications, and repeat/revision or alternate procedure after failure. Effects measured as change in quality-adjusted life years ( QALY) from preprocedure to 2 years postprocedure. Incremental cost-effectiveness ratios were determined, and sensitivity analysis conducted. The mild ® strategy appears to be the most cost-effective ($43,760/ QALY), with ESI the next best alternative at an additional $37,758/ QALY. Laminectomy surgery was the least cost-effective ($125,985/ QALY). [ABSTRACT FROM AUTHOR] |
| Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 100766299 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: The 2-Year Cost-Effectiveness of 3 options to Treat Lumbar Spinal Stenosis Patients. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Udeh%2C+Belinda+L%2E%22">Udeh, Belinda L.</searchLink><br /><searchLink fieldCode="AR" term="%22Costandi%2C+Shrif%22">Costandi, Shrif</searchLink><br /><searchLink fieldCode="AR" term="%22Dalton%2C+Jarrod+E%2E%22">Dalton, Jarrod E.</searchLink><br /><searchLink fieldCode="AR" term="%22Ghosh%2C+Raktim%22">Ghosh, Raktim</searchLink><br /><searchLink fieldCode="AR" term="%22Yousef%2C+Hani%22">Yousef, Hani</searchLink><br /><searchLink fieldCode="AR" term="%22Mekhail%2C+Nagy%22">Mekhail, Nagy</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Pain+Practice%22">Pain Practice</searchLink>. Feb2015, Vol. 15 Issue 2, p107-116. 10p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Economic+impact%22">Economic impact</searchLink><br /><searchLink fieldCode="DE" term="%22Medicare%22">Medicare</searchLink><br /><searchLink fieldCode="DE" term="%22Spinal+stenosis+treatment%22">Spinal stenosis treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Cost+effectiveness%22">Cost effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Lumbar+vertebrae%22">Lumbar vertebrae</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Quality-adjusted+life+years%22">Quality-adjusted life years</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Lumbar spinal stenosis ( LSS) may result from degenerative changes of the spine, which lead to neural ischemia, neurogenic claudication, and a significant decrease in quality of life. Treatments for LSS range from conservative management including epidural steroid injections ( ESI) to laminectomy surgery. Treatments vary greatly in cost and success. ESI is the least costly treatment may be successful for early stages of LSS but often must be repeated frequently. Laminectomy surgery is more costly and has higher complication rates. Minimally invasive lumbar decompression ( mild ® ) is an alternative. Using a decision-analytic model from the Medicare perspective, a cost-effectiveness analysis was performed comparing mild ® to ESI or laminectomy surgery. The analysis population included patients with LSS who have moderate to severe symptoms and have failed conservative therapy. Costs included initial procedure, complications, and repeat/revision or alternate procedure after failure. Effects measured as change in quality-adjusted life years ( QALY) from preprocedure to 2 years postprocedure. Incremental cost-effectiveness ratios were determined, and sensitivity analysis conducted. The mild ® strategy appears to be the most cost-effective ($43,760/ QALY), with ESI the next best alternative at an additional $37,758/ QALY. Laminectomy surgery was the least cost-effective ($125,985/ QALY). [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/papr.12160 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 107 Subjects: – SubjectFull: Economic impact Type: general – SubjectFull: Medicare Type: general – SubjectFull: Spinal stenosis treatment Type: general – SubjectFull: Cost effectiveness Type: general – SubjectFull: Lumbar vertebrae Type: general – SubjectFull: Research funding Type: general – SubjectFull: Quality-adjusted life years Type: general – SubjectFull: Data analysis software Type: general – SubjectFull: Descriptive statistics Type: general Titles: – TitleFull: The 2-Year Cost-Effectiveness of 3 options to Treat Lumbar Spinal Stenosis Patients. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Udeh, Belinda L. – PersonEntity: Name: NameFull: Costandi, Shrif – PersonEntity: Name: NameFull: Dalton, Jarrod E. – PersonEntity: Name: NameFull: Ghosh, Raktim – PersonEntity: Name: NameFull: Yousef, Hani – PersonEntity: Name: NameFull: Mekhail, Nagy IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 02 Text: Feb2015 Type: published Y: 2015 Identifiers: – Type: issn-print Value: 15307085 Numbering: – Type: volume Value: 15 – Type: issue Value: 2 Titles: – TitleFull: Pain Practice Type: main |
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