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The cost-effectiveness, in terms of costs per Quality-Adjusted Life Year (QALY) gained (Dutch threshold \u20ac20,000-\u20ac80,000) or minimal important change (MIC) in disability reduced (DASH 6.7), is unknown. The aim of this study was to determine cost-utility and cost-effectiveness of operative versus nonoperative treatment in adults with a humeral shaft fracture type 12A or 12B.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This study was performed alongside a multicenter prospective cohort study. Costs for health care and lost productivity until one\u00a0year after trauma were calculated. The incremental cost-utility ratio (ICUR) was reported in costs per QALY (based on the\u00a0EuroQoL-5D-3L (EQ-5D)) gained. The incremental cost-effectiveness ratio (ICER) was reported in costs per MIC (based on the\u00a0DASH score\u00a0at three months) reduced.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, 245 patients\u00a0were treated operatively and 145 nonoperatively. In the operative group, the mean total costs per patient (\u20ac11,925 versus \u20ac8793; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and QALYs (0.806 versus 0.778; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were higher. The ICUR of operative treatment was \u20ac111,860 per QALY gained (<jats:italic>i.e.<\/jats:italic>, \u20ac3132\/0.028). The DASH was 7.3 points\u00a0(<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) lower in the operative group. The ICER of operative treatment was \u20ac2880 per MIC in disability reduced (<jats:italic>i.e.<\/jats:italic>, \u20ac3132\/7.3*6.7).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Due to the limited effect of treatment on quality of life measured with the EQ-5D, the ICUR of operative treatment (\u20ac111,860 per QALY gained) exceeds the threshold. However, the incremental costs of \u20ac2880 per clinically meaningful difference in DASH are much lower and suggest that operative treatment for a humeral shaft fracture is cost-effective.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-022-02160-1","type":"journal-article","created":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T16:10:58Z","timestamp":1670515858000},"page":"929-938","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Economic evaluation of operative versus nonoperative treatment of a humeral shaft fracture: economic analyses alongside a multicenter prospective cohort study (HUMMER)"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3308-2412","authenticated-orcid":false,"given":"Saskia H.","family":"Van Bergen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2597-7948","authenticated-orcid":false,"given":"Esther M. 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