| Title |
Cost Effectiveness of Venous Thromboembolism Pharmacological Prophylaxis in Total Hip and Knee Replacement
|
|---|---|
| Published in |
PharmacoEconomics, September 2012
|
| DOI | 10.2165/11535210-000000000-00000 |
| Pubmed ID | |
| Authors |
Alok Kapoor, Warren Chuang, Nila Radhakrishnan, Kenneth J. Smith, Dan Berlowitz, Jodi B. Segal, Jeffrey N. Katz, Elena Losina |
| Abstract |
Total hip and knee replacements (THR and TKR) are high-risk settings for venous thromboembolism (VTE). This review summarizes the cost effectiveness of VTE prophylaxis regimens for THR and TKR. We searched MEDLINE (January 1997 to October 2009), EMBASE (January 1997 to June 2009) and the UK NHS Economic Evaluation Database (1997 to October 2009). We analysed recent cost-effectiveness studies examining five categories of comparisons: (i) anticoagulants (warfarin, low-molecular-weight heparin [LMWH] or fondaparinux) versus acetylsalicylic acid (aspirin); (ii) LMWH versus warfarin; (iii) fondaparinux versus LMWH; (iv) comparisons with new oral anticoagulants; and (v) extended-duration (> or =3 weeks) versus short-duration (<3 weeks) prophylaxis. We abstracted information on cost and effectiveness for each prophylaxis regimen in order to calculate an incremental cost-effectiveness ratio. Because of variations in effectiveness units reported and horizon length analysed, we calculated two cost-effectiveness ratios, one for the number of symptomatic VTE events avoided at 90 days and the other for QALYs at the 1-year mark or beyond. Our search identified 33 studies with 67 comparisons. After standardization, comparisons between LMWH and warfarin were inconclusive, whereas fondaparinux dominated LMWH in nearly every comparison. The latter results were derived from radiographic VTE rates. Extended-duration prophylaxis after THR was generally cost effective. Small numbers prohibit conclusions about aspirin, new oral anticoagulants or extended-duration prophylaxis after TKR. Fondaparinux after both THR and TKR and extended-duration LMWH after THR appear to be cost-effective prophylaxis regimens. Small numbers for other comparisons and absence of trials reporting symptomatic endpoints prohibit comprehensive conclusions. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 81 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Korea, Republic of | 1 | 1% |
| United States | 1 | 1% |
| France | 1 | 1% |
| Unknown | 78 | 96% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 12 | 15% |
| Researcher | 9 | 11% |
| Other | 9 | 11% |
| Student > Master | 8 | 10% |
| Student > Postgraduate | 7 | 9% |
| Other | 17 | 21% |
| Unknown | 19 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 38 | 47% |
| Pharmacology, Toxicology and Pharmaceutical Science | 6 | 7% |
| Social Sciences | 3 | 4% |
| Nursing and Health Professions | 2 | 2% |
| Agricultural and Biological Sciences | 2 | 2% |
| Other | 7 | 9% |
| Unknown | 23 | 28% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 March 2018.
All research outputs
#6,378,772
of 22,663,969 outputs
Outputs from PharmacoEconomics
#709
of 1,811 outputs
Outputs of similar age
#46,421
of 171,171 outputs
Outputs of similar age from PharmacoEconomics
#12
of 56 outputs
Altmetric has tracked 22,663,969 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 1,811 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one has gotten more attention than average, scoring higher than 59% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 171,171 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 71% of its contemporaries.
We're also able to compare this research output to 56 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 78% of its contemporaries.