PIH43 EARLY ASSESSMENT OF A NEW TREATMENT FOR ADOLESCENT IDIOPATHIC SCOLIOSIS

Abstract

OBJECTIVES: Adolescent idiopathic scoliosis (AIS) reduces the quality of life. It can lead to back pain, reduced back function and socio-psychological problems. Left untreated it may induce cardio-vascular and pulmonary problems, and even death. Current treatment of severe forms of idiopathic scoliosis are based on fusion of the vertebrae. These treatments restrict back function and growth of the adolescents. This study aims to conduct an early technology assessment of a new non-fusion scoliosis correction system. METHODS: The early assessment of this new treatment is supported by the Analytic Hierarchy Process (AHP), a technique for multi-criteria decision analysis. The AHP quantifies the comparison between the performances of decision alternatives under a finite set of decision criteria. An expert panel composed of six technological engineers and medical specialists compared the expected performance of the new non-fusion treatment to the performance of posterior fusion surgery for patients with severe AIS. They regarded criteria related to the quality of life, complications, user friendliness and costs. RESULTS: The expert panel considered the influence of the treatment on the quality of life to be most important (weight 0.46) followed by complications (0.35), user friendliness (0.11) and costs (0.09). They expected the new non-fusion treatment to particularly have a more positive influence on the quality of life (priority 0.73) than posterior surgery has (priority 0.27). Main disadvantage was considered to be the relative high costs of the new treatment (priority 0.37 versus 0.63). In overall, the new treatment is expected to slightly outperform the current treatment (priority 0.63 versus 0.37). CONCLUSIONS: In the absence of clinical evidence, this method provides a valuable means to systematically predict a new technology’s clinical value. The outcomes provide clear directions for medical industry to improve the future cost-effectiveness of new treatments.