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Clarke A, Pulikottil-Jacob R, Grove A, et al. Total hip replacement and surface replacement for the treatment of pain and disability resulting from end-stage arthritis of the hip (review of technology appraisal guidance 2 and 44): systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2015 Jan. (Health Technology Assessment, No. 19.10.)

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Total hip replacement and surface replacement for the treatment of pain and disability resulting from end-stage arthritis of the hip (review of technology appraisal guidance 2 and 44): systematic review and economic evaluation.

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Chapter 2Definition of the decision problem

Decision problem

This report aims to evaluate the clinical effectiveness and cost-effectiveness of THR and hip RS for the treatment of pain and disability in people with arthritis. More specifically, we aim to investigate, in people with pain and disability resulting from arthritis of the hip for whom non-surgical management has failed:

  1. the clinical effectiveness and cost-effectiveness of different types of elective primary THR compared with primary hip RS in those suitable for both procedures
  2. the clinical effectiveness and cost-effectiveness of different types of primary THR compared with each other in those not suitable for hip RS.

Overall aims and objectives

  1. To undertake a systematic review of the clinical effectiveness and cost-effectiveness of (a) different types of primary THR compared with RS for people in whom both procedures are suitable and (b) different types of primary THR compared with each other for people who are not suitable for hip RS and to investigate factors that influence benefits and costs. If data are sufficient, the influence of patient- and intervention-related factors on the magnitude of treatment effects will be explored through subgroup analysis and meta-regression.
  2. To further develop the cost-effectiveness and cost–utility models published in TA4425 using updated NJR data and model inputs when available.
  3. To report on findings and make recommendations for future research.

This report aims to evaluate the clinical effectiveness and cost-effectiveness of THR and RS for the treatment of pain and disability in people with arthritis [Table 7 provides a summary of the population, intervention, comparator/control and outcome (PICO)].

TABLE 7

TABLE 7

Population, intervention, comparator/control and outcome table

Copyright © Queen’s Printer and Controller of HMSO 2015. This work was produced by Clarke et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.

Included under terms of UK Non-commercial Government License.

Bookshelf ID: NBK273988
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