title: The cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains.
abstract: OBJECTIVE
  To examine the cost-effectiveness of semi-rigid ankle brace to facilitate return to work following first-time acute ankle sprains.
  
  
  METHODS
  Economic evaluation based on cost-utility analysis.
  
  
  BACKGROUND
  Ankle sprains are a source of morbidity and absenteeism from work, accounting for 15-20% of all sports injuries. Semi-rigid ankle brace and taping are functional treatment interventions used by Musculoskeletal Physiotherapists and Nurses to facilitate return to work following acute ankle sprains.
  
  
  METHODS
  A decision model analysis, based on cost-utility analysis from the perspective of National Health Service was used. The primary outcomes measure was incremental cost-effectiveness ratio, based on quality-adjusted life years. Costs and quality of life data were derived from published literature, while model clinical probabilities were sourced from Musculoskeletal Physiotherapists.
  
  
  RESULTS
  The cost and quality adjusted life years gained using semi-rigid ankle brace was £184 and 0.72 respectively. However, the cost and quality adjusted life years gained following taping was £155 and 0.61 respectively. The incremental cost-effectiveness ratio for the semi-rigid brace was £263 per quality adjusted life year. Probabilistic sensitivity analysis showed that ankle brace provided the highest net-benefit, hence the preferred option.
  
  
  CONCLUSIONS
  Taping is a cheaper intervention compared with ankle brace to facilitate return to work following first-time ankle sprains. However, the incremental cost-effectiveness ratio observed for ankle brace was less than the National Institute for Health and Care Excellence threshold and the intervention had a higher net-benefit, suggesting that it is a cost-effective intervention. Decision-makers may be willing to pay £263 for an additional gain in quality adjusted life year.
  
  
  CONCLUSIONS
  The findings of this economic evaluation provide justification for the use of semi-rigid ankle brace by Musculoskeletal Physiotherapists and Nurses to facilitate return to work in individuals with first-time ankle sprains.
authors.affiliation: Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
authors.forename: Francis
authors.initials: F
authors.lastname: Fatoye
authors.affiliation: Department of Nursing, Manchester Metropolitan University, Manchester, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Haigh
mesh_terms: D016512:Ankle Injuries / Q000451:nursing / Q000534:rehabilitation*; D001915:Braces / Q000191:economics*; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D006801:Humans; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D062707:Return to Work; D013222:State Medicine; D006113:United Kingdom
keywords: ankle injury; ankle support; economic analysis, absenteeism, physiotherapist; taping