A scoping literature review of studies assessing effectiveness and cost-effectiveness of prosthetic and orthotic interventions

Abstract

Purpose: Approximately 1.5% of the world's population (~100 million people) need a prosthesis/orthosis. The objective of the study was to establish an overview of the literature that has examined prosthetic and orthotic interventions with a view to inform policy development.Methods: Fourteen databases were searched from 1995-2015. Studies reporting primary research on the effectiveness or cost-effectiveness of prosthetic and orthotic interventions were examined. Metadata and information on study characteristics were extracted from the included studies.Results: The searches resulted in a total of 28,958 articles, a focus on studies with the words "randomised" OR "randomized" OR "cost" OR "economic" in their citation reduced this total to 2,644. Research has predominantly been conducted in Australia, Canada, Germany, Netherlands, UK and USA. 346 randomised controlled trials were identified, with only four randomised controlled trials examining prosthetic interventions. The majority of research examined lower limb orthoses in the adult population and used a wide range of outcome measures. Conclusions: While various international organisations have highlighted the value of providing prosthetic and orthotic services, both to the user and society as a whole, the availability of scientific research to inform policy is limited. Future structured evaluation of prosthetic and orthotic interventions/services is warranted to inform future policy developments.

User-relevant factors determining prosthesis choice in persons with major unilateral upper limb defects: A meta-synthesis of qualitative literature and focus group results

“…This observation implies that the introduction of more advanced types of hand prostheses indeed resulted in an increase of costs. However, cost-effectiveness of upper limb prostheses has not been thoroughly investigated [50]. To allow making evidence-based and cost-effective decisions regarding prosthesis choice, studies that compare the functionality, satisfaction and cost-effectiveness of upper limb prosthesis users are needed.…”

Prioritizing solutions to incorporate Prosthetics and Orthotics services into Iranian health benefits package: Using an analytic hierarchy process

“…Cost-effective interventions in the HBP were also one of the solutions explored in this study. Although recent investigations have reported on the cost-effectiveness of a number of P&O interventions [47,48], some evidence has criticized mere focus on economic dimensions, arguing that social values and equity should be considered in the insurance coverage [36,49]. In this line, cost-effective interventions achieved one of the lowest priorities based on the fairness criterion in the AHP in this study.…”

A review of the effect of a Walker ankle-foot orthosis on gait biomechanics in healthy individuals

“…There are many types of ankle orthoses with different functions or used in different cases. Orthotics can be used for people with both neurological and orthopedic problems [5]. Walker boots are used by people who have experienced acute trauma to the ankle complex such as fractures, severe ankle sprains and patients who have undergone surgery in this area [6].What is more, Walker orthoses may be prescribed to patients as part of conservative treatment or cast substitute after surgical treatment of Achilles tendon rupture.…”