Below you will find brief descriptions of several of our exciting ongoing analyses. To learn more about our past, published work, please refer to the Publications page.
Cost-Effectiveness of Gabapentinoids for Treatment of Knee Osteoarthritis
Gabapentinoids are brain stabilizing drugs that have traditionally been used to treat epilepsy and other seizure disorders as an anticonvulsant. Recently, they have shown promise in treating persons with centralized pain symptoms. Historically, people with knee OA were thought to only experience nociceptive pain as an individual’s pain profile originates from their index knee. New literature suggests that for some people, this targeted pain turns into a more centralized, neuropathic, pain. In this analysis, we investigate whether it is cost-effective to use gapabentinoids as a pain-reducing treatment for people with knee OA who show signs of centralized, rather than nociceptive, pain profiles. Additionally, we examine the ability of gabapentinoid use to delay or diminish the use of opioids in knee OA pain treatment.
Cost-Effectiveness of Antibiotic Prophylaxis following TKR in Patients with Type II Diabetes
The administration of antibiotic prophylaxis (AP) before dental procedures following total knee replacement (TKR) remains inconclusive and controversial. Certain comorbidities, including type II diabetes mellitus, are associated with increased odds of developing infections. In this analysis, we aim to evaluate the cost-effectiveness of administering AP prior to dental visits among TKR recipients with type II diabetes mellitus. This research evaluates whether the reduction in prosthetic joint infections outweighs the impacts of adverse reactions to antibiotics.
Cost-Effectiveness of Arthroscopic Partial Meniscectomy for Meniscal Tear
Meniscal tear (MT) is a highly prevalent condition in the US, for which arthroscopic partial meniscectomy (APM) has long been a standard treatment. Recent research, though, suggests that APM may be comparable to physical therapy (PT) in radiographic and self-reported benefits for patients with MT. This analysis, which uses five-year follow-up data from the MeTeOR trial, will evaluate the cost-effectiveness of APM versus PT for treatment of MT.
Cost-Effectiveness of Duloxetine for Treatment of Knee Osteoarthritis
Generic duloxetine, historically used to treat depression, is approved as treatment for knee osteoarthritis (OA). In this analysis, we investigate whether it is cost-effective to use duloxetine as a treatment for people with knee OA who have tried unsuccessfully to use non-steroidal anti-inflammatory drugs (NSAIDs) to manage their knee pain.
Cost of Opioid Use Among People with Knee Osteoarthritis
A certain subset of people with knee osteoarthritis (OA) use opioids for pain management. Opioid use carries direct medical costs as well as costs to society. These societal costs may be from lost workplace productivity, criminal justice, or diverted opioid prescriptions. We plan to analyze the cost of opioid use in the knee OA population in the United States.
Optimizing Pain Management for Persons with Depression and Osteoarthritis
Depression is associated with greater pain severity in persons with osteoarthritis (OA). Treating depression has been shown to reduce pain, but most adults with OA and depression do not receive adequate depression treatment. Duloxetine, a serotonin-norepinephrine reuptake inhibitor, has been shown to reduce both depressive symptoms and pain. This analysis aims to evaluate the clinical and economic impact of treating knee OA patients with depression with duloxetine in addition to usual care.
Cost-Effectiveness of Bariatric Surgery Among Morbidly Obese Persons with Knee Osteoarthritis
Obesity, defined as having a BMI>30kg/m2, is a potent risk factor for knee osteoarthritis (KOA). Indeed, the risk of developing KOA increases with BMI to the extent that nearly 85% of those with KOA are overweight or obese, and the prevalence of KOA is over 55% among morbidly obese people (BMI>35 kg/m2). Given the potentially large impact that weight-reduction surgery may have on the development and progression of KOA, we aim to evaluate the cost-effectiveness of Roux-en-Y Gastric Bypass (RYGB) among morbidly obese persons with KOA. In this analysis, we consider the clinical and economic impacts of RYGB, including the magnitude and duration of weight loss and knee pain reduction, the effect of surgery on comorbidities such as cardiovascular disease and type 2 diabetes, and the probability, cost, and impact on quality of life of perioperative complications.