Charlotte Bosman, Corry van der Sluis, Aline Vrieling, Jan Geertzen, Bregje Seves, Henk Groen

RESPONSE TO THE LETTER TO THE EDITOR REGARDING "HEALTH ECONOMIC EVALUATION OF MICROPROCESSOR AND NON-MICROPROCESSOR-CONTROLLED PROSTHETIC KNEES"

Introduction

Response to the letter to the editor regarding "health economic evaluation of microprocessor and non-microprocessor-controlled prosthetic knees". Clarifies health economic evaluation of microprocessor and non-microprocessor prosthetic knees, explaining ICUR values & costing. Highlights future research needs.

Abstract

We responded to comments by Brüggenjürgen et al. (https://doi.org/10.33137/cpoj.v8i2.46339) regarding our study on cost-effectiveness of different prosthesis types (https://doi.org/10.33137/cpoj.v8i2.45823). We explained why small effect differences lead to high ICUR values and clarify our costing approach. We emphasized the need for future studies on prosthesis life-cycle, long-term outcomes, and improved quality-of-life measures for more accurate evaluations. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/46486/34608 How To Cite: Bosman C.E, van der Sluis C.K, Vrieling A.H, Geertzen J.H.B, Seves B.L, Groen H. Response to the letter to the editor regarding “Health economic evaluation of microprocessor and non-microprocessor-controlled prosthetic knees". Canadian Prosthetics & Orthotics Journal. 2025; Volume 8, Issue 2, No. 7. https://doi.org/10.33137/cpoj.v8i2.46486 Corresponding Author: Professor Henk Groen, Affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.E-Mail: h.groen01@umcg.nlORCID ID: https://orcid.org/0000-0002-6629-318X

Review

This article serves as a direct response to a letter to the editor from Brüggenjürgen et al., critically examining a prior health economic evaluation conducted by the present authors. The original study, a significant contribution to the field, assessed the cost-effectiveness of microprocessor versus non-microprocessor-controlled prosthetic knees. In this response, the authors aim to address the specific comments and concerns raised by their peers, providing clarification and a robust defense of the methodology and findings presented in their initial publication. The authors meticulously address two primary points of contention. Firstly, they elucidate the nuanced relationship between small observed effect differences and the resultant high Incremental Cost-Utility Ratios (ICURs), a critical methodological consideration in health economic evaluations that often leads to misinterpretation. Secondly, they provide a detailed clarification of their costing approach, which was evidently a focal point of the critical letter. This transparent and analytical engagement with peer feedback underscores the scientific rigor and commitment to defensible methodology. Beyond defending their original work, the authors contribute positively to the ongoing scientific discourse by outlining crucial areas for future research. They emphasize the paramount need for studies that delve into the full life-cycle of prostheses, assess long-term patient outcomes, and develop improved, more sensitive quality-of-life measures. This forward-looking perspective not only acknowledges the limitations of current data but also highlights the complexities inherent in achieving truly comprehensive and accurate health economic evaluations within the specialized field of prosthetics.

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