RESEARCH
JAMA
Weinstein J, Tosteson T, Lurie JD, Tosteson ANA, Hancome B, Skinner JS, Abdu WA, Hilibrand, AS, Boden SD, Deyo RA
Lumbar diskectomy is the most common surgical procedure performed for back and leg symptoms in US patients, but the efficacy of the procedure relative to nonoperative care remains controversial.
JAMA
Weinstein J, Lurie JD, Tosteson T, Skinner JS, Hanscom B, Tosteson ANA, Herkowitz H, Fischgrund J, Cammisa F, Albert T, Deyo R
For patients with lumbar disk herniation, the Spine Patient Outcomes Research Trial (SPORT) randomized trial intent-to-treat analysis showed small but not statistically significant differences in favor of diskectomy compared with usual care. However, the large numbers of patients who crossed over between assigned groups precluded any conclusions about the comparative effectiveness of operative therapy vs usual care.
Journal of Bone and Joint Surgery
Skinner JS, Zhou W, Weinstein J
The associations among income, total knee arthroplasty, and underlying rates of knee osteoarthritis are not well understood. We study whether high income Medicare recipients are more likely to have a knee arthroplasty and less likely to suffer from knee osteoarthritis.
Health Affairs
Skinner JS, Staiger D, Fisher ES
We examine Medicare costs and survival gains for acute myocardial infarction (AMI) during 1986–2002. As David Cutler and Mark McClellan did in earlier work, we find that overall gains in post-AMI survival more than justified the increases in costs during this period. Since 1996, however, survival gains have stagnated, while spending has continued to increase. We also consider changes in spending and outcomes at the regional level. Regions experiencing the largest spending gains were not those realizing the greatest improvements in survival. Factors yielding the greatest benefits to health were not the factors that drove up costs, and vice versa.
