{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T10:45:50Z","timestamp":1785235550139,"version":"3.55.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,5,22]],"date-time":"2022-05-22T00:00:00Z","timestamp":1653177600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Platelet-rich plasma (PRP) or corticosteroid injections may be used to conservatively treat mild-to-moderate carpal tunnel syndrome (CTS). We evaluated the cost-effectiveness of PRP injections versus corticosteroid injections for the treatment of mild-to-moderate CTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Markov modeling was used to analyze the base-case 45-year-old patient with mild-to-moderate CTS, unresponsive to conservative treatments, never previously treated with an injection or surgery, treated with a single injection of PRP, or methylprednisolone\/triamcinolone 40 mg\/mL. Transition probabilities were derived from level-I\/II studies, utility values from the Tufts University Cost-Effectiveness Analysis Registry reported using visual analog scale (VAS), Boston Carpal Tunnel Questionnaire Symptom severity (BCTQ-S), and Boston Carpal Tunnel Questionnaire Functional status (BCTQ-F), and costs from Medicare, published studies, and industry. Analyses were performed from healthcare\/societal perspectives. Outcomes were incremental cost-effectiveness ratios (ICER) and net monetary benefits (NMB). Willingness-to-pay thresholds were $50\u2009000 and $100\u2009000. Deterministic\/probabilistic sensitivity analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From a healthcare perspective, compared to PRP injections, the ICER for corticosteroid injections measured by VAS: -$13.52\/quality-adjusted-life-years (QALY), BCTQ-S: -$11.88\/QALY, and BCTQ-F: -$16.04\/QALY. PRP versus corticosteroid injections provided a NMB measured by VAS: $428\u2009941.12 versus $375\u2009788.21, BCTQ-S: $417\u2009115.09 versus $356\u2009614.18, and BCTQ-F: $421\u2009706.44 versus $376\u2009908.45. From a societal perspective, compared to PRP injections, the ICER for corticosteroid injections measured by VAS: -$1024.40\/QALY, BCTQ-S: -$899.95\/QALY, and BCTQ-F: -$1215.51\/QALY. PRP versus corticosteroid injections provided a NMB measured by VAS: $428\u2009171.63 versus $373\u2009944.39, BCTQ-S: $416\u2009345.61 versus $354\u2009770.36, and BCTQ-F: $420\u2009936.95 versus $375\u2009064.63.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>PRP injections were more cost-effective than methylprednisolone\/triamcinolone injections from healthcare and societal perspectives for mild-to-moderate CTS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447221092056","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T01:16:31Z","timestamp":1653268591000},"page":"113-127","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Platelet-Rich Plasma Versus Corticosteroid Injections for the Treatment of Mild-to-Moderate Carpal Tunnel Syndrome: A Markov Cost-Effectiveness Decision Analysis"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2742-4319","authenticated-orcid":false,"given":"Kevin M.","family":"Klifto","sequence":"first","affiliation":[{"name":"University of Missouri School of Medicine, Columbia, USA"},{"name":"Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S.","family":"Klifto","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0300-2883","authenticated-orcid":false,"given":"Tyler S.","family":"Pidgeon","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc J.","family":"Richard","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Ruch","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen H.","family":"Colbert","sequence":"additional","affiliation":[{"name":"University of Missouri School of Medicine, Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,5,22]]},"reference":[{"key":"bibr1-15589447221092056","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200906000-00007"},{"key":"bibr2-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2020.09.007."},{"key":"bibr3-15589447221092056","unstructured":"Graham B, Peljovich AE, Afra R, et al. Management of carpal tunnel syndrome: evidence-based clinical practice guideline adopted by the american academy of orthopaedic surgeons (AAOS) board of directors. 2016. https:\/\/aaos.org\/globalassets\/quality-and-practice-resources\/carpal-tunnel\/management-of-carpal-tunnel-syndrome-7-31-19.pdf. Accessed April 7, 2021."},{"key":"bibr4-15589447221092056","doi-asserted-by":"publisher","DOI":"10.2106\/jbjs.19.01354"},{"key":"bibr5-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X9301300409"},{"key":"bibr6-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1177\/2381468318765162"},{"key":"bibr7-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1405158"},{"key":"bibr8-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.12195"},{"key":"bibr9-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-019-04719-7"},{"key":"bibr10-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1080\/2000656X.2016.1260025"},{"key":"bibr11-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1186\/s41983-020-00184-1"},{"key":"bibr12-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejr.2018.07.008"},{"key":"bibr13-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1177\/1753193412475247"},{"key":"bibr14-15589447221092056","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200207000-00003"},{"key":"bibr15-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1177\/1558944718812129"},{"key":"bibr16-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2666-z"},{"key":"bibr17-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1053\/jhsu.2003.50080"},{"key":"bibr18-15589447221092056","unstructured":"Stark B, Engkvist-L\u00f6fmark C. Endoscopic operation or conventional open surgical technique in carpal tunnel syndrome: a prospective comparative study. Handchir Mikrochir Plast Chir. 1996;28(3):128-132. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/8767942. Accessed April 5, 2022."},{"key":"bibr19-15589447221092056","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5413.30527"},{"key":"bibr20-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(09)91044-9"},{"key":"bibr21-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-013-1898-z"},{"key":"bibr22-15589447221092056","unstructured":"U.S. Centers for Medicare & Medicaid Services. Search the physician fee schedule. http:\/\/www.cms.gov\/apps\/physician-fee-schedule\/search\/search-criteria.aspx. Updated 2021. Accessed April 7, 2021."},{"key":"bibr23-15589447221092056","unstructured":"Arthrex Inc. Arthrex ACP\u00ae double-syringe system. https:\/\/www.arthrex.com\/orthobiologics\/autologous-conditioned-plasma\/products. Updated 2021. Accessed April 10, 2021."},{"key":"bibr24-15589447221092056","unstructured":"U.S. Centers for Medicare & Medicaid Services. Medicare part B drug average sales price. https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Part-B-Drugs\/McrPartBDrugAvgSalesPrice. Updated 2021. Accessed April 7, 2021."},{"key":"bibr25-15589447221092056","unstructured":"Agency for Healthcare Research and Quality (AHRQ). Using appropriate price indices for expenditure comparisons. https:\/\/meps.ahrq.gov\/about_meps\/Price_Index.shtml#a3. Updated 2019. Accessed April 19, 2021."},{"key":"bibr26-15589447221092056","unstructured":"U.S. Department of Commerce. U.S. Census Bureau. PINC-09. Source of income-number with income and mean income of specified type of people 15 years old and over, by age, race, Hispanic origin, and sex. https:\/\/www.census.gov\/data\/tables\/time-series\/demo\/income-poverty\/cps-pinc\/pinc-09.html. Updated 2020. Accessed April 7, 2021."},{"key":"bibr27-15589447221092056","unstructured":"Bureau of Labor Statistics, U. S. Department of Labor. Occupational outlook handbook, home health and personal care aides. https:\/\/www.bls.gov\/ooh\/healthcare\/home-health-aides-and-personal-care-aides.htm. Updated 2021. Accessed April 10, 2021."},{"key":"bibr28-15589447221092056","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2019.8483"},{"key":"bibr29-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1002\/psb.1562"},{"key":"bibr30-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-016-0482-0"},{"key":"bibr31-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2020.11.014"},{"key":"bibr32-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-00224-6"},{"key":"bibr33-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000101055.76543.C7"},{"key":"bibr34-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-018-1963-4"},{"key":"bibr35-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-59113-0"},{"key":"bibr36-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1142\/S2424835519500474"},{"key":"bibr37-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1097\/00008505-200110000-00002"},{"key":"bibr38-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1160\/TH03-07-0440"},{"key":"bibr39-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1590\/1518-8345.3265.3221"},{"key":"bibr40-15589447221092056","doi-asserted-by":"publisher","DOI":"10.1177\/2325967119900811"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447221092056","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15589447221092056","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447221092056","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:28:10Z","timestamp":1777447690000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15589447221092056"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,22]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1177\/15589447221092056"],"URL":"https:\/\/doi.org\/10.1177\/15589447221092056","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,22]]}}}