An Analysis of the Plastic Surgery Cost-Utility Literature Using a Novel Scoring Tool (original) (raw)
Related papers
Plastic & Reconstructive Surgery, 2014
he last two decades have seen an increasing push to control healthcare spending, and cost-utility analyses have become critical in promoting scientifically based procedure comparisons. This pressure is especially relevant for plastic surgery given that the field is epitomized by novel technique, intervention, and procedure development. However, there is a general lack of familiarity regarding the proper use of health economic evaluations in the plastic surgery literature. The term "cost-effective" is often used to narrowly compare direct costs in plastic surgery, but full economic evaluations, including indirect costs and quality of life, are rare. 1,2 In plastic surgery, only 3 percent of outcomes studies have costs as an endpoint, and only 6 percent of economic evaluations are cost-utility studies. 3 This article aims to address these shortcomings in two ways. First, using a simple scoring tool, this article aims to facilitate a standard design of plastic surgery cost-utility studies as a means to improve their quality. Second, the article identifies the areas that need improvement by scoring the plastic surgery utility literature.
Economic models for evaluating plastic surgery ideas
Journal of Plastic, Reconstructive & Aesthetic Surgery, 2013
This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.
The utility of outcome studies in plastic surgery
Plastic and reconstructive surgery. Global open, 2014
Outcome studies help provide the evidence-based science rationalizing treatment end results that factor the experience of patients and the impact on society. They improve the recognition of the shortcoming in clinical practice and provide the foundation for the development of gold standard care. With such evidence, health care practitioners can develop evidence-based justification for treatments and offer patients with superior informed consent for their treatment options. Furthermore, health care and insurance agencies can recognize improved cost-benefit options in the purpose of disease prevention and alleviation of its impact on the patient and society. Health care outcomes are ultimately measured by the treatment of disease, the reduction of symptoms, the normalization of laboratory results and physical measures, saving a life, and patient satisfaction. In this review, we outline the tools available to measure outcomes in plastic surgery and subsequently allow the objective meas...
A methodological guide to performing a cost-utility study comparing surgical techniques
The Canadian journal of plastic surgery = Journal canadien de chirurgie plastique, 2004
When recommending the adoption of a new surgical intervention as opposed to maintaining an old one, surgeons need to consider the opportunity cost, which is the value of the forgone benefits. To inform these decisions, surgeons can use economic analyses of surgical practices. Unfortunately, economic analyses conducted alongside randomized controlled trials in surgery are rare. The objective of the present study was to use data from a small randomized controlled trial to illustrate the methodology for a cost-utility analysis comparing two techniques of carpal tunnel release: open release without ('usual' technique) and with ('novel' technique) ligament reconstruction. Eighteen eligible patients were entered into this prospective study. Fifteen were followed to six weeks postoperatively. One day preoperatively, and five days, three weeks and six weeks postoperatively, patients completed a self-administered Health Utilities Index Mark 2-3 questionnaire (utilities) and a...
Methodologic Quality of Cost-Effectiveness Analyses of Surgical Procedures
Objective: The purpose of this study was to evaluate the methodologic quality of economic analyses of surgical procedures and to compare quality across publications. Summary Background Data: With healthcare resources limited and technologies rapidly advancing across specialties, including surgery, there is increasing demand for evidence of cost-effectiveness. Methods: A MEDLINE search identified English-language articles published from 1995 to 2004 that included economic analyses of surgical procedures. Two of the authors reviewed 110 studies and scored each based on compliance with 10 methodologic criteria. Data analyses used Cohen's kappa statistic, regression models, Mann-Whitney U tests, and Kruskal-Wallis tests. Results: The 110 articles appeared in 79 different journals, including 57 articles in 37 surgical journals. Most journals (75%) had only 1 article eligible for inclusion. The average number of criteria met was 4.1, with 10 articles meeting all 10 methodologic standards. Compliance rates for the 5 methodologic criteria most frequently neglected ranged from 34% to 45% in nonsurgical journals and 9% to 14% in surgical journals (P 0.001). Conclusions: While methodologic guidelines for cost-effectiveness analyses have appeared in the medical literature, studies of cost-effectiveness in surgery often do not meet these criteria. As healthcare policy seeks to incorporate information from economic evaluations, it is increasingly important that surgical journals adhere to accepted guidelines and perform quality assurance on these studies. This may be aided by wider promulgation of the methodologic criteria in surgical journals or at surgical meetings. (Ann Surg 2007;245: 147–151)
Economic Evaluations in Surgery
2019
New innovations in surgery are common, and often touted as being cost-effective with the recommendation to adopt them into practice. Unfortunately, the term “cost-effective” is, more often than not, misused in the surgical literature. This misuse may have direct consequences if surgeons adopt new techniques or approaches that are not truly cost-effective. In this chapter, readers will be introduced to common terminology used in economic evaluations. This chapter, explains the four main forms of economic evaluations: Cost Analysis (CA), Cost-Effectiveness Analysis (CEA) , Cost–Utility Analysis (CUA) , and Cost–Benefit Analysis (CBA). It will also help the reader appraise and understand an article that purports to be an economic evaluation in surgery. Finally, hopefully, it will stimulate surgeon-investigators to perform economic evaluations parallel to Randomized Controlled Trials that compare a novel intervention to standard practice.
Cost outcomes of facial plastic surgery: regional and temporal trends
Archives of facial plastic surgery
To describe the geographic and temporal trends in cosmetic facial plastic surgery procedure costs and frequency during the last decade and to evaluate factors that may influence changes in the demand for cosmetic procedures. A survey sent to every (N = 1727) active fellow, member, or associate of the American Academy of Facial Plastic and Reconstructive Surgery assessing the costs and frequency of 4 common cosmetic facial plastic surgery procedures (ie, face-lift, brow lift, blepharoplasty, and rhinoplasty) for 1999 and 1989. The annual frequency of the aging-face procedures (ie, face-lift, brow lift, and blepharoplasty) have increased 41% over the last decade while rhinoplasties have declined slightly (18%). Each of the procedures studied have increased in cost since 1989; however, only face-lifts have increased at a rate greater than inflation during this period (average surgeon's fees, 3154−3154-3154−4582). Although the average cost of each of these procedures is stable across US geo...
Value in Oral and Maxillofacial Surgery: A Systematic Review of Economic Analyses.
J Oral Maxillofac Surg., 2017
PURPOSE: The purpose of this study is to describe the state of economic analyses in the field of oral and maxillofacial surgery (OMS). MATERIALS AND METHODS: A systematic search of published literature up to 2016 was performed. The inclusion criteria were as follows: English-language articles on economic analyses pertaining to OMS including anesthesia and pain management; dentoalveolar surgery; orthognathic, cleft, and/or obstructive sleep apnea treatment; pathology; reconstruction; temporomandibular disorders; trauma; and other. The exclusion criteria were as follows: opinion or perspective articles, studies unrelated to OMS, nonhuman research, and implant-related studies. Cost-effectiveness analyses (CEAs), cost-utility analyses, and cost-minimization analyses (CMAs) were evaluated with the original Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist or a modified CHEERS checklist. RESULTS: The search yielded 798 articles, 77 of which met the inclusion criteria (published from 1980 to 2016, 48 from the United States). There were an increasing number of studies over time (P for trend < .01). There were 7 economic studies on anesthesia and pain management (9.1%); 16 studies on dentoalveolar surgery (20.7%); 15 studies on orthognathic, cleft, and/or obstructive sleep apnea treatment (19.4%); 1 study on pathology (1.3%); 6 studies on reconstruction (7.8%); no studies on temporomandibular joint disorders and/or facial pain (0%); 20 studies on trauma (25.9%); and 12 studies categorized as other (15.5%). CEAs made up 11.7% of studies, and CMAs comprised 58.4%. Of the 9 CEAs, 55.6% were published in 2010 or later. Of the 45 CMAs, 88.6% were published in 2000 or later and 61.4% in 2010 or later. CEAs met 56.0% (range, 29.2 to 87.5%) of the CHEERS criteria, whereas CMA studies met 45.1% (range, 23.9 to 76.1%) of the modified CHEERS criteria. Only 1 study succeeded in estimating costs and health outcomes (value) of an OMS procedure. CONCLUSIONS: There is an increasing trend in the number of economic studies in the field of OMS. More high-quality economic evaluations are needed to demonstrate the value of OMS procedures. To determine value, future studies should compare both costs and health-related outcomes.
Evidence-Based Plastic Surgery: Its Rise, Importance, and a Practical Guide
Aesthetic Surgery Journal, 2016
There is a perfect storm developing in 21st century healthcare; rising complexity and patient expectations in the context of fiscal restraint. Evidence-based medicine (EBM) may be the best-kept secret in dealing with the "storm." Such an approach prefers management pathways that deliver better outcomes at less relative cost. In this article, the rise of EBM, its significance, a guide to practicing it, and its future in the field of plastic, reconstructive, and aesthetic surgery are presented.