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Guide to Statistics and Methods
January 29, 2020

Practical Guide to Cost-effectiveness Analysis

Author Affiliations
  • 1Department of Surgery, University of Utah School of Medicine, Salt Lake City
  • 2Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City
  • 3Department of Emergency Medicine, Harbor-UCLA (University of California, Los Angeles) Medical Center, Torrance
  • 4David Geffen School of Medicine at UCLA, Los Angeles
  • 5Department of Surgery, Veterans Affairs Boston Health Care System, Boston, Massachusetts
  • 6Department of Surgery, Boston University, Boston, Massachusetts
  • 7Department of Surgery, Harvard Medical School, Boston, Massachusetts
JAMA Surg. 2020;155(3):250-251. doi:10.1001/jamasurg.2019.4392

Constraints on US health care resources provide incentives to maximize outcomes among surgical patients while limiting the costs of providing care. Cost-effectiveness analysis (CEA) is a statistical method that allows researchers to simultaneously compare the trade-offs between costs and health effects of different surgical interventions. The resultant metrics can help inform decisions about adopting new or existing interventions, particularly when many surgical procedures are expensive and benefits are uncertain over time. For example, the results of CEA have been used to help surgeons choose between alternative techniques for creating arteriovenous fistulas for hemodialysis in patients with end-stage renal disease.1 Similarly, a recent study published in JAMA Surgery applied CEA methods to assess the relative value of bariatric surgery (compared with no surgery) over time among adolescent patients with severe obesity.2

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