Determining the Best Treatment for Simple Bone Cyst: A Decision Analysis
Clinics in Orthopedic Surgery
;
: 62-71, 2014.
Artigo
em Inglês
| WPRIM
| ID: wpr-68300
ABSTRACT
BACKGROUND:
The treatment of simple bone cysts (SBC) in children varies significantly among physicians. This study examined which procedure is better for the treatment of SBC, using a decision analysis based on current published evidence.METHODS:
A decision tree focused on five treatment modalities of SBC (observation, steroid injection, autologous bone marrow injection, decompression, and curettage with bone graft) were created. Each treatment modality was further branched, according to the presence and severity of complications. The probabilities of all cases were obtained by literature review. A roll back tool was utilized to determine the most preferred treatment modality. One-way sensitivity analysis was performed to determine the threshold value of the treatment modalities. Two-way sensitivity analysis was utilized to examine the joint impact of changes in probabilities of two parameters.RESULTS:
The decision model favored autologous bone marrow injection. The expected value of autologous bone marrow injection was 0.9445, while those of observation, steroid injection, decompression, and curettage and bone graft were 0.9318, 0.9400, 0.9395, and 0.9342, respectively. One-way sensitivity analysis showed that autologous bone marrow injection was better than that of decompression for the expected value when the rate of pathologic fracture, or positive symptoms of SBC after autologous bone marrow injection, was lower than 20.4%.CONCLUSIONS:
In our study, autologous bone marrow injection was found to be the best choice of treatment of SBC. However, the results were sensitive to the rate of pathologic fracture after treatment of SBC. Physicians should consider the possibility of pathologic fracture when they determine a treatment method for SBC.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Transplante Autólogo
/
Cistos Ósseos
/
Árvores de Decisões
/
Análise de Variância
/
Transplante de Medula Óssea
/
Guias de Prática Clínica como Assunto
Tipo de estudo:
Guia de Prática Clínica
/
Avaliação Econômica em Saúde
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Clinics in Orthopedic Surgery
Ano de publicação:
2014
Tipo de documento:
Artigo
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