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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Specialistläkare Ortopedi och handkirurgi, Docent Cecilia Mellstrand Navarro, Handkirurgiska kliniken Södersjukhuset og Karolinska Institutet
- Second opponent: Professor II Hebe Desiré Kvernmo, Universitetet i Tromsø
- Third member and chair of the evaluation committee: Professor Magne Røkkum, University of Oslo
Chair of the Defence
Professor Emeritus Vegard Dahl, Faculty of Medicine, University of Oslo
Principal Supervisor
Senior Consultant Per-Henrik Randsborg, Akershus Universitetssykehus
Summary
Over the last two decades, VLP has become the most common surgical method to treat displaced DRFs in adults, despite no clear evidence that VLP provides better functional or patient reported outcome - or is cost-effective - compared to EF. The aim of the present study was therefore to meticulously compare the objective and subjective outcome of EF and VLP for displaced intraarticular DRFs, conduct an in-depth assessment of the responsiveness for widely used PROMs, and perform a detailed cost utility analysis, considering both direct (health service related) costs and societal costs, such as productivity loss due to work absenteeism.
After two years, there were no substantial differences in functional or patient reported outcome between patients treated with either VLP or EF. However, the VLP group had improved results the first year, and returned to work earlier that the patients in the EF group. When evaluating the responsiveness of EQ-5D and SF-6D to QuickDASH, we found that QuickDASH correlates well with EQ-5D on a group level, but with large individual variations. SF-6D was less responsive in the early postoperative period and did not provide additional information to EQ-5D. It can therefore be left out in future studies of outcome following surgical treatment of DRF. Finally, we found that the healthcare costs of VLP and EF are similar, but from a societal point of view VLP is cost-effective compared to EF, due to a higher degree of work absenteeism in the EF group.
In summary, this thesis supports the use of VLP as the method of choice when operating displaced DRFs due to quicker recovery for the patients and reduced cost for society. EQ-5D is an appropriate generic measure for quality of life and health economic analysis, while SF-6D can be omitted.
Additional information
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