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Design, Conduct, and Interpretation of Nonrandomized Orthopaedic Studies--A Practical Approach   |    
Using Observational Data for Decision Analysis and Economic Analysis
Carmen A. Brauer, MD, MSc, FRCSC1; Kevin J. Bozic, MD, MBA2
1 Division of Orthopedic Surgery, University of Calgary Alberta Children's Hospital, 2888 Shaganappi Trail N.W., Calgary, AB T3B 6A8, Canada
2 Department of Orthopaedic Surgery and Philip R. Lee Institute for Health Policy Studies, 500 Parnassus Avenue, MU320W, San Francisco, CA 94143-0728. E-mail address: bozick@orthosurg.ucsf.edu
View Disclosures and Other Information
Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from the Alberta Heritage Foundation for Medical Research. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 May 01;91(Supplement 3):73-79. doi: 10.2106/JBJS.H.01537
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Abstract

In orthopaedic surgery, clinical decisions must often be made with imperfect information from observational studies and limited resources. Decision analysis and cost-effectiveness analysis have emerged as evidence-based tools to assist in making choices in situations in which uncertainty exists. This review demonstrates how decision-analysis and cost-effectiveness-analysis tools can be used to expand on published observational studies within the context of a specific clinical scenario. Critical evaluation of clinical and economic data is of increasing importance in today's health-care delivery climate. The use of decision analysis and cost-effectiveness analysis as tools to augment observational studies can assist clinicians, patients, and policy makers in choosing techniques that will optimize benefits. A clear understanding of and the ability to use and apply these tools will allow surgeons to participate effectively in health-policy decisions to enhance the overall quality and efficiency of care that is delivered.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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