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Is reduction of routine radiograph use in patients with distal radius fractures cost effective? Analysis of data from the multicentre, randomized controlled WARRIOR trial

BMJ Open Jul 09, 2020

van Gerven P, van Dongen JM, Rubinstein SM, et al. - Researchers performed an economical evaluation in addition to a multicentre randomized controlled trial including 341 patients, in order to ascertain the cost effectiveness of a reduced imaging follow-up protocol of distal radius fractures compared with usual care. Participants were randomized to either usual care (n = 172; routine radiography at 1, 2, 6 and 12 weeks) or a reduced imaging strategy (n = 169; radiographs at 6 and 12 weeks only for a clinical indication). In the reduced imaging group, patients received on average 3.3 radiographs (SD: 1.9) vs 4.2 (SD: 1.9) in the usual care group. Significantly lower costs for radiographic imaging were reported in the reduced imaging group vs the usual care group (€−48 per patient). Outcomes suggest that in the follow-up of distal radius fractures, implementation of a reduced imaging strategy has a high probability of being cost effective for quality-adjusted life years, with no reduction in functional outcome. Based on these findings, they emphasize conducting imaging only when clinically indicated.

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