{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:08:56Z","timestamp":1793408936801,"version":"4.5.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Displaced femoral neck fractures are a significant source of morbidity and mortality and can be treated with either hemiarthroplasty (HA) or total hip arthroplasty (THA). Proponents of THA have argued THA offers lower risk of revision, with improved functional outcomes when compared to HA. To evaluate cost effectiveness of THA compared with HA, a trial-based economic analysis of the HEALTH study was undertaken.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Health care resource utilization (HRU) and health-related quality of life (HRQoL) data were collected postoperatively and costed using publicly available databases. Using EuroQol-5 Dimensions (EQ-5D) scores, we derived quality adjusted life years (QALYs). A 1.5% discount rate to both costs and QALYs was applied. Age analyses per age group were conducted. All costs are reported in 2019 Canadian dollars.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>When compared with HA, THA was not cost-effective for all patients with displaced femoral neck fractures ($150,000\/QALY gained). If decision makers were willing to spend $50,000 or $100,000 to gain one QALY, the probability of THA being cost-effective was 12.8% and 32.8%, respectively. In a subgroup of patients younger than 73 (first quartile), THA was both more effective and less costly. Otherwise, THA was more expensive and yielded marginal HRQoL gains.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Our results suggest that for most patients, THA is not a cost-effective treatment for displaced femoral neck fracture management versus HA. However, THA may be cost effective for younger patients. These patients experience more meaningful improvements in quality of life with less associated cost because of shorter hospital stay and fewer postoperative complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Economic Level II. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000001932","type":"journal-article","created":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T09:00:26Z","timestamp":1601974826000},"page":"S37-S41","source":"Crossref","is-referenced-by-count":15,"title":["Is Total Hip Arthroplasty a Cost-Effective Option for Management of Displaced Femoral Neck Fractures? A Trial-Based Analysis of the HEALTH Study"],"prefix":"10.1097","volume":"34","author":[{"given":"Daniel","family":"Axelrod","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-\u00c9ric","family":"Tarride","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada;"},{"name":"Center for Health Economics and Policy Analysis (CHEPA), McMaster University, and Programs for Assessment of Technology in Health (PATH), The Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada;"},{"name":"McMaster Chair in Health Technology Management Hamilton, Hamilton, ON, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seper","family":"Ekhtiari","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Blackhouse","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada;"},{"name":"Center for Health Economics and Policy Analysis (CHEPA), McMaster University, and Programs for Assessment of Technology in Health (PATH), The Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Johal","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Bzovsky","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil H.","family":"Schemitsch","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Western Ontario, London, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Heels-Ansdell","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohit","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada;"},{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Sprague","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada;"},{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the HEALTH Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230828","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s00391-018-1382-z","article-title":"Epidemiology of hip fractures","volume":"52","author":"Rapp","year":"2019","journal-title":"Z Gerontol Geriatr."},{"key":"R2-20230828","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1016\/j.injury.2018.04.015","article-title":"Epidemiology and social costs of hip fracture","volume":"49","author":"Veronese","year":"2018","journal-title":"Injury."},{"key":"R3-20230828","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1177\/1120700018803933","article-title":"The national burden of periprosthetic hip fractures in the US: costs and risk factors for hospital readmission","volume":"29","author":"Reeves","year":"2019","journal-title":"Hip Int."},{"key":"R4-20230828","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1016\/j.arth.2019.03.070","article-title":"Hemiarthroplasty vs total hip arthroplasty for the management of displaced neck of femur fractures: a systematic review and meta-analysis","volume":"34","author":"Lewis","year":"2019","journal-title":"J Arthroplasty."},{"key":"R5-20230828","article-title":"Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fracture: a systematic review and meta-analysis of randomized controlled trials","author":"Ekthiari","year":"2020","journal-title":"J Bone Joint Surg Am"},{"key":"R7-20230828","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1056\/NEJMoa1906190","article-title":"Total hip arthroplasty or hemiarthroplasty for hip fracture","volume":"381","author":"Bhandari","year":"2019","journal-title":"N Engl J Med."},{"key":"R10-20230828","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1302\/2046-3758.33.2000250","article-title":"Outcome assessment after hip fracture: is EQ-5D the answer?","volume":"3","author":"Parsons","year":"2014","journal-title":"Bone Joint Res."},{"key":"R11-20230828","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.jval.2016.11.015","article-title":"Instrument-defined estimates of the minimally important difference for EQ-5D-5L index scores","volume":"20","author":"McClure","year":"2017","journal-title":"Value Heal."},{"key":"R12-20230828","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jval.2015.02.001","article-title":"Cost-effectiveness analysis alongside clinical trials II\u2014an ISPOR good research practices task force report","volume":"18","author":"Ramsey","year":"2015","journal-title":"Value Heal."},{"key":"R13-20230828","doi-asserted-by":"crossref","first-page":"f1049","DOI":"10.1136\/bmj.f1049","article-title":"Consolidated health economic evaluation reporting standards (CHEERS) statement","volume":"346","author":"Husereau","year":"2013","journal-title":"BMJ."},{"key":"R14-20230828","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1177\/0272989X9801800312","article-title":"Uncertainty in decision models analyzing cost-effectiveness: the joint distribution of incremental costs and effectiveness evaluated with a nonparametric bootstrap method","volume":"18","author":"Hunink","year":"1998","journal-title":"Med Decis Mak."},{"key":"R15-20230828","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/j.jval.2016.02.017","article-title":"Country-level cost-effectiveness thresholds: initial estimates and the need for further research","volume":"19","author":"Woods","year":"2016","journal-title":"Value Heal."},{"key":"R17-20230828","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1007\/s00198-016-3484-z","article-title":"Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study","volume":"27","author":"Burgers","year":"2016","journal-title":"Osteoporos Int."},{"key":"R18-20230828","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.arth.2008.05.008","article-title":"A cost-effectiveness analysis of the arthroplasty options for displaced femoral neck fractures in the active, healthy, elderly population","volume":"24","author":"Slover","year":"2009","journal-title":"J Arthroplasty."},{"key":"R19-20230828","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/01.blo.0000150273.13949.62","article-title":"Total hip arthroplasty: optimal treatment for displaced femoral neck fractures in elderly patients","volume":"429","author":"Healy","year":"2004","journal-title":"Clin Orthop Relat Res."},{"key":"R21-20230828","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/S0020-1383(00)00125-X","article-title":"Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur--13 year results of a prospective randomised study","volume":"31","author":"Ravikumar","year":"2000","journal-title":"Injury."}],"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000001932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T02:57:31Z","timestamp":1693191451000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000001932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000001932","relation":{},"ISSN":["0890-5339"],"issn-type":[{"value":"0890-5339","type":"print"}],"subject":[],"published":{"date-parts":[[2020,11]]}}}