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Related Experiment Videos

Nice hips: shame about the conclusions.

A D Toms1, M Jiggins, G Prosser

  • 1New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton England.

Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
|January 27, 2017
PubMed
Summary
This summary is machine-generated.

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This study questions the National Institute for Clinical Excellence (NICE) guidelines on hip replacement prostheses, finding their evidence and conclusions on cemented vs. uncemented options unclear.

Area of Science:

  • Orthopaedic Surgery
  • Health Technology Assessment

Background:

  • The National Institute for Clinical Excellence (NICE) released its first surgical appraisal in April 2000, focusing on primary total hip replacement prostheses.
  • NICE faced criticism for its perceived role in healthcare rationing within medical recommendations.
  • The appraisal committee's composition included only two orthopaedic surgeons.

Purpose of the Study:

  • To critically examine the NICE appraisal committee's conclusions on hip replacement prostheses.
  • To evaluate the evidence base used by the committee.
  • To identify overlooked evidence regarding prosthesis selection.

Main Methods:

  • Analysis of the NICE appraisal document and its cited evidence.
  • Review of the evidence considered by the appraisal committee.

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  • Identification and assessment of evidence not included in the appraisal.

    • Main Results:

    • The methodology for determining the ten-year benchmark for prostheses was unclear.
    • The appraisal overemphasized the benefits of less expensive cemented prostheses.
    • Evidence supporting more costly uncemented and hybrid prostheses was not fully considered.

    Conclusions:

    • The NICE appraisal's conclusions regarding hip replacement prostheses lack clear justification.
    • The guideline may not adequately reflect the full evidence spectrum for optimal prosthesis selection.
    • Further scrutiny of health technology assessment methodologies in orthopaedics is warranted.