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Intervention thresh...
Intervention thresholds for osteoporosis
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- Kanis, JA (författare)
- University of Sheffield
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- Johnell, Olof (författare)
- Lund University,Lunds universitet,Ortopedi - klinisk och molekylär osteoporosforskning,Forskargrupper vid Lunds universitet,Orthopedics - Clinical and Molecular Osteoporosis Research,Lund University Research Groups,Malmö University
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Oden, A (författare)
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- De Laet, C (författare)
- Erasmus MC
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- Oglesby, A (författare)
- Eli Lilly
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- Jönsson, Bengt (författare)
- Stockholm School of Economics,Handelshögskolan i Stockholm
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(creator_code:org_t)
- 2002
- 2002
- Engelska.
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Ingår i: Bone. - 1873-2763. ; 31:1, s. 26-31
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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https://research.hhs...
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Abstract
Ämnesord
Stäng
- The aim of this study was to determine the threshold of fracture probability at which interventions become cost-effective. We modeled the effects of a treatment costing $500/year, given for 5 years, that decreased the risk of all osteoporotic fractures by 35%, followed by a waning of effect for 5 years. Sensitivity analyses included a range of effectiveness (10%-50%) and a range of intervention costs ($200-500/year). Data on costs and risks were from Sweden. Costs included direct costs and costs in added years of life, but excluded indirect costs due to morbidity. A threshold for cost-effectiveness of $60,000 per quality-adjusted life-year (QALY) gained was used. Costs of added years were excluded in a sensitivity analysis for which a threshold value of $30,000 per QALY was used. In the base case, intervention was cost-effective when treatment was targeted to women at average risk at age of greater than or equal to65 years. Irrespective of the efficacy modeled (10%-50%) or of cost of intervention ($200-500/year) segments of the population at average risk could be targeted cost-effectively: The lower the intervention cost and the higher the effectiveness, the lower the age at which intervention was cost-effective. With the base case ($500/year; 35% efficacy) treatment in women was cost-effective with a 10 year hip fracture probability that ranged from 1.4% at the age of 50 years to 4.4% at the age of 65 years. The exclusion of osteoporotic fractures other than hip fracture would increase the threshold to a 9%-11% 10 year probability because of the substantial morbidity from fractures other than hip fracture, particularly at younger ages. We conclude that the inclusion of all osteoporotic fractures has a marked effect on intervention thresholds, that these vary with age, and that available treatments can be cost-effectively targeted to individuals at moderately increased risk.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Nyckelord
- osteoporotic fracture
- cost of added years
- threshold
- cost-effectiveness
- intervention
- hip fracture
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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