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- Borgstrom, F., et al.
(author)
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Health economic aspects of vertebral augmentation procedures
- 2015
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In: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 26:4, s. 1239-1249
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Research review (peer-reviewed)abstract
- We reviewed all peer-reviewed papers analysing the cost-effectiveness of vertebroplasty and balloon kyphoplasty for osteoporotic vertebral compression fractures. In general, the procedures appear to be cost effective but are very dependent upon model input details. Better data, rather than new models, are needed to answer outstanding questions. Vertebral augmentation procedures (VAPs), including vertebroplasty (VP) and balloon kyphoplasty (BKP), seek to stabilise fractured vertebral bodies and reduce pain. The aim of this paper is to review current literature on the cost-effectiveness of VAPs as well as to discuss the challenges for economic evaluation in this research area. A systematic literature search was conducted to identify existing published studies on the cost-effectiveness of VAPs in patients with osteoporosis. Only peer-reviewed published articles that fulfilled the criteria of being regarded as full economic evaluations including both morbidity and mortality in the outcome measure in the form of quality-adjusted life years (QALYs) were included. The search identified 949 studies, of which four (0.4 %) were identified as relevant with one study added later. The reviewed studies differed widely in terms of study design, modelling framework and data used, yielding different results and conclusions regarding the cost-effectiveness of VAPs. Three out of five studies indicated in the base case results that VAPs were cost effective compared to non-surgical management (NSM). The five main factors that drove the variations in the cost-effectiveness between the studies were time horizon, quality of life effect of treatment, offset time of the treatment effect, reduced number of bed days associated with VAPs and mortality benefit with treatment. The cost-effectiveness of VAPs is uncertain. In answering the remaining questions, new cost-effectiveness analysis will yield limited benefit. Rather, studies that can reduce the uncertainty in the underlying data, especially regarding the long-term clinical outcomes of VAPs, should be conducted.
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| 3. |
- Monaghan, T., et al.
(author)
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Solid-state additive manufacturing for metallized optical fiber integration
- 2015
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In: Composites. Part A, Applied science and manufacturing. - Kidlington : Pergamon Press. - 1359-835X .- 1878-5840. ; 76, s. 181-193
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Journal article (peer-reviewed)abstract
- The formation of smart, Metal Matrix Composite (MMC) structures through the use of solid-state Ultrasonic Additive Manufacturing (UAM) is currently hindered by the fragility of uncoated optical fibers under the required processing conditions. In this work, optical fibers equipped with metallic coatings were fully integrated into solid Aluminum matrices using processing parameter levels not previously possible. The mechanical performance of the resulting manufactured composite structure, as well as the functionality of the integrated fibers, was tested. Optical microscopy, Scanning Electron Microscopy (SEM) and Focused Ion Beam (FIB) analysis were used to characterize the interlaminar and fiber/matrix interfaces whilst mechanical peel testing was used to quantify bond strength. Via the integration of metallized optical fibers it was possible to increase the bond density by 20–22%, increase the composite mechanical strength by 12–29% and create a solid state bond between the metal matrix and fiber coating; whilst maintaining full fiber functionality. © 2015 The Authors. Published by Elsevier Ltd.
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