Second opinion column in the surgery indications: evaluation of cost-effectiveness

• Grant number: 15/50352-6
• Support type: Research Grants - Research Partnership for Technological Innovation - PITE
• Duration: September 01, 2016 - December 31, 2018
• Field of knowledge: Health Sciences - Medicine - Surgery
• Cooperation agreement: Instituto de Estudos de Saúde Suplementar (IESS)
• Principal Investigator: Mario Ferretti Filho
• Grantee: Mario Ferretti Filho
• Home Institution: Hospital Israelita Albert Einstein. Sociedade Beneficente Israelita Brasileira Albert Einstein (SBIBAE). São Paulo , SP, Brazil
• Company: Instituto de Estudos de Saúde Suplementar (IESS)
• City: São Paulo

Abstract

The objectives of this study are to: 1) assess the cost-effectiveness of second opinion for spine surgery; 2) evaluate the effectiveness of conservative and surgical treatments for degenerative lumbar spine diseases; 3) define objective criteria of conservative and surgical treatment using evidence-based medicine; 4) evaluate the prognostic of biomarkers; 5) compare the diagnoses and recommended management of patients with private health insurance who had received an initial recommendation for spinal surgery from a community-based spinal surgeon; 6) verify the effectiveness of the patients who underwent surgery, compared with patients who did not undergo surgery. We will conduct a prospective cohort study, which will evaluate patients with surgical treatment of the spine directed to a second opinion. We will compare the diagnoses and recommended management of patients with private health insurance who had received an initial recommendation for spinal surgery from a community-based spinal surgeon, and who were offered a second opinion at a private not-for-profit philanthropic hospital, by their private health insurers. The secondary aim was to compare functional and quality of life endpoints in a cohort of patients who were subsequently treated at the second opinion Hospital with either surgery or conservative care. We will assess the cost-effectiveness outcomes, pain, quality of life, function and biologics markers. (AU)