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External fixation versus amputation in the treatment of ulcerated diabetic foot: a cost-utility analysis using real-world data and a discrete-event simulation model

Pablo Roberto Miguel et al.

Cost Effectiveness and Resource Allocation2026https://doi.org/10.1186/s12962-025-00704-xarticle
ABDC C
Weight
0.50

What the paper says

Diabetic foot is a severe complication of diabetes mellitus, with a significant impact on patients’ quality of life. The traditional treatment has been amputation, but its high mortality rate has prompted a search for alternatives, such as the resection of non-viable tissue and limb stabilization using external fixation. This study evaluates the cost-effectiveness relationship between these two strategies. An assessment was made of the incremental cost-effectiveness ratio (ICER), calculated over a ten-year time horizon, of both amputation and external fixation. The analysis was based on clinical and cost data obtained from a previous study and used a discrete event simulation model. The mean ten-year quality-adjusted life expectancy for amputated patients was 2.641 ± 1.64 quality-adjusted life years (QALYs) as compared with 6.627 ± 1.46 QALYs for patients treated with external fixation (p < 0.001). The average cost-effectiveness ratio (CER) was estimated at €29,717/QALY for amputation and €15,360/QALY for external fixation. A comparison between both options resulted in an ICER of €5,847/QALY. Sensitivity analyses found ICER values ranging between €5,847/QALY and €12,296/QALY. A budget impact analysis revealed that the incorporation of the new treatment alternative into the Spanish National Health System would lead to a budget increase of €528.2 million over a ten-year horizon. The use of external fixation in the treatment of ulcerated diabetic foot was shown to be a cost-effective option compared to major amputations.

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https://doi.org/https://doi.org/10.1186/s12962-025-00704-x

Or copy a formatted citation

@article{pablo2026,
  title        = {{External fixation versus amputation in the treatment of ulcerated diabetic foot: a cost-utility analysis using real-world data and a discrete-event simulation model}},
  author       = {Pablo Roberto Miguel et al.},
  journal      = {Cost Effectiveness and Resource Allocation},
  year         = {2026},
  doi          = {https://doi.org/https://doi.org/10.1186/s12962-025-00704-x},
}

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External fixation versus amputation in the treatment of ulcerated diabetic foot: a cost-utility analysis using real-world data and a discrete-event simulation model

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Evidence weight

0.50

Balanced mode · F 0.40 / M 0.15 / V 0.05 / R 0.40

F · citation impact0.50 × 0.4 = 0.20
M · momentum0.50 × 0.15 = 0.07
V · venue signal0.50 × 0.05 = 0.03
R · text relevance †0.50 × 0.4 = 0.20

† Text relevance is estimated at 0.50 on the detail page — for your query’s actual relevance score, open this paper from a search result.