hta_ knee intro.qxp - Ministero della Salute

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4. Objectives, policy and research questions The policy question of this HTA report was the following: Are the prostheses for total <strong>knee</strong> replacement (TKR) currently used clinical practice in Italy supported by sufficient evidence? Can performance of the devices be linked to their price? This policy question can be broken down into the following research questions: • Which prostheses for TKR are used in Italy? • What is the evidence of effectiveness and safety from the literature of TKR prostheses used in Italy? • What is the evidence of effectiveness from registers of TKR prostheses used in Italy? • What are the costs of each single prosthesis model? • What are the cost effectiveness indicators of the TKR prostheses used in Italy? The following main objectives were used to draft this report: • to identify and describe the TKR prostheses currently used in Italy (“context”); • to retrieve and assess the available evidence about effectiveness and safety of the prostheses for primary TKR used in Italy; • to collect TKR prostheses data on effectiveness and safety from arthroplasty registers; • to compare TKR prostheses performance from published studies with data from arthroplasty registers; • to carry out an economic analysis of the TKR prostheses prices in Italy; • to create a cost-effectiveness model for the evaluation of the TKR prostheses and their performance. 9
Page 1 and 2: HTA REPORT Prostheses for primary t
Page 3 and 4: Contributions Authors Marina Cerbo,
Page 5 and 6: HTA REPORT Prostheses for primary t
Page 7 and 8: 10. Recommendations . . . . . . . .
Page 9: Prefazione Quest’anno l’Agenas
Page 12 and 13: XII Results Literature in this fiel
Page 14 and 15: XIV Obiettivi del report L’interv
Page 16 and 17: XVI formati e delle variabili racco
Page 18 and 19: 2 The procedures were identified ac
Page 21 and 22: 2. Technology, procedure and altern
Page 23: 3. The marketing status of knee pro
Page 28 and 29: 12 Among the 147 sampled centres, t
Page 30 and 31: 14 Table 5.2: Responding centres Re
Page 32 and 33: 16 Figure 5.3: Number of total knee
Page 34 and 35: 18 Table 5.4: Volume of purchased p
Page 36 and 37: 20 Table 5.5: List of mean weighted
Page 39 and 40: 6. Assessing the evidence from clin
Page 41 and 42: Figure 6.1: Flow diagram of the inc
Page 43 and 44: We initially intended to compare re
Page 47: Table 6.2: Summary of the registry-
Page 50 and 51: 34 chapter 6 for the systematic rev
Page 52 and 53: 36 Table 7.2: Results of the prelim
Page 54 and 55: 38 Since the characteristics of pat
Page 56 and 57: 40 Table 7.5: Data from the Austral
Page 58 and 59: 42 Table 7.7: Data from the Austral
Page 60 and 61: 44 Table 7.9: Data from New Zealand
Page 62 and 63: 46 Table 7.13: Data from the Austra
Page 64 and 65: 48 pared to those from a single reg
Page 67 and 68: 8. Economic model and cost-effectiv
Page 69 and 70: However in the absence of meaningfu
Page 71 and 72: Table 8.2: ICER (RIPO data) for sin
Page 73 and 74: Figure 8.2: Cost-effectiveness repr
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9. Discussion The present report wa
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The data loss due to a narrow study
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11. Funding Production of this repo
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Bibliography 1. British Association
Page 87 and 88:
Appendix 1 Technological characteri
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Materials used in TKR Metal alloys
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Biomechanics of physiologic and rep
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new sequentially cross-linked polye
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Sharma, A., Komistek, R.D., Ranawat
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82 1. VOLUME OF ACTIVITY N° of pro
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88 Finally, we increased the sample
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Appendix 4 List of responding centr
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Umbria: 100803 Presidio Ospedaliero
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Appendix 5 List of manufacturers Th
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98 replacement AND [1998-2009] /py
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100 #76. (natural AND ('knee'/exp O
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102 #134. stryker AND primary AND t
Page 120 and 121:
104 #202. chart AND stick AND (how
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106 ing" and "smith & nephew" and p
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108
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110 Population: Total number of pat
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112 Synthesis of the results: Devic
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114
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116
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118
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120 Studies excluded for irrelevant
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122 Jordan LR, Sorrells RB, Jordan
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124 Campbell DG, Duncan WW, Ashwort
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126
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128
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130 RDM Repertorio nazionale dei di
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