Analysis of shoulder arthroplasty literature finds the procedure to be cost-effective

Recently published results show total shoulder arthroplasty is a cost-effective procedure and, according to quality of health economic studies scores, most cost analysis literature on the subject is high quality.

William M. Cregar, MD, and colleagues performed a systematic review of nine studies and examined the cost-effectiveness of total shoulder arthroplasty for the treatment of various shoulder pathologies. A total of 196 studies were screened for inclusion.

Cregar and colleagues used the quality of health economic studies (QHES) instrument to evaluate the quality of the cost analyses. They also performed one-sided Fisher exact testing to identify predictors of low-quality (< 25th percentile QHES score) and high-quality (> 75th percentile QHES score) research, according to the study.

“The average QHES score among all studies was 86.22,” the researchers wrote in the study. “Failure to include an annual cost discounting rate was associated with a low-quality QHES score. In addition, including a discussion of the magnitude and direction of potential biases was associated with a high-quality score,” they added.

“We believe the value of cost-effectiveness research within the field of orthopedics, and in particular shoulder surgery, is critical as considerations of cost have become emphasized more heavily within our health care system,” the researchers wrote. “Cost-effectiveness literature has the ability to critically evaluate new technology or interventions with significant implications regarding its subsequent implementation and coverage,” they concluded.