title: The SPORT value compass: do the extra costs of undergoing spine surgery produce better health benefits?
abstract: BACKGROUND
  The Spine Patient Outcomes Research Trial aimed to determine the comparative effectiveness of surgical care versus nonoperative care by measuring longitudinal values: outcomes, satisfaction, and costs.
  
  
  METHODS
  This paper aims to summarize available evidence from the Spine Patient Outcomes Research Trial by addressing 2 important questions about outcomes and costs for 3 types of spine problem: (1) how do outcomes and costs of spine patients differ depending on whether they are treated surgically compared with nonoperative care? (2) What is the incremental cost per quality adjusted life year for surgical care over nonoperative care?
  
  
  RESULTS
  After 4 years of follow-up, patients with 3 spine conditions that may be treated surgically or nonoperatively have systematic differences in value endpoints. The average surgical patient enjoys better health outcomes and higher treatment satisfaction but incurs higher costs.
  
  
  CONCLUSIONS
  Spine care is preference sensitive and because outcomes, satisfaction, and costs vary over time and between patients, data on value can help patients make better-informed decisions and help payers know what their dollars are buying.
authors.affiliation: *The Dartmouth-Hitchcock Medical Center †The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH ‡Geisel School of Medicine at Dartmouth, Hanover, NH.
authors.forename: James N
authors.initials: JN
authors.lastname: Weinstein
authors.forename: Anna N A
authors.initials: AN
authors.lastname: Tosteson
authors.forename: Tor D
authors.initials: TD
authors.lastname: Tosteson
authors.forename: Jon D
authors.initials: JD
authors.lastname: Lurie
authors.forename: William A
authors.initials: WA
authors.lastname: Abdu
authors.forename: Sohail K
authors.initials: SK
authors.lastname: Mirza
authors.forename: Wenyan
authors.initials: W
authors.lastname: Zhao
authors.forename: Tamara S
authors.initials: TS
authors.lastname: Morgan
authors.forename: Eugene C
authors.initials: EC
authors.lastname: Nelson
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D005260:Female; D006304:Health Status; D006801:Humans; D017116:Low Back Pain / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D020127:Recovery of Function; D013131:Spine / Q000601:surgery*