. 2020 Aug 17;12(1):15–23. doi: 10.1177/2192568220944888

Table 2.

Cost/DALY Analysis Comparing Operative Versus Nonoperative Treatment in 4 Patient Scenarios.

	Quadriplegic Cervical, ASIA A-C N = 20 DALYs (3, 1, 0.04)- DALYs (0, 0, 0)^a		Paraplegic Thoracic/lumbar, ASIA A-C N = 66 DALYs (3, 1, 0.04)- DALYs (0, 0, 0)^a		Neurologically improved Improved to ASIA D-E N = 18 DALYs (3, 1, 0.04)- DALYs (0, 0, 0)^a		Neurologically intact, unstable fracture Maintained ASIA E N = 13 DALYs (3, 1, 0.04)- DALYs (0, 0, 0)^a
	Operative	Nonoperative^b	Operative	Nonoperative^b	Operative	Nonoperative^b	Operative	Nonoperative^b
Total costs^c ($)	14 004-14 620	4061-4240	46 212-48 246	13 402-13 992	12 603-13 158	3655-3816	9102-9503	2640-2756
Total DALYs	348-824	414-912	711-2138	1222-2829	98-444	230-622	49-300	165-458
DALYs averted with surgery compared to without surgery^d	66-89		511-691		132-178		116-158
Incremental cost-effectiveness ratio (cost/DALY averted)^e ($)	112-158		47-67		50-71		41-58

Abbreviation: ASIA, American Spinal Injury Association.

^a Disability-adjusted life-years (DALYs); DALYs (r, k, b): r is the discount rate, k is whether age-weighting was used (0 = no, 1 = yes), and b is the age-weighting value. DALYs are reported as a range, where DALYs (3, 1, 0.04) is the lower limit and DALYs (0, 0, 0) is the upper limit.

^b Sample sizes are from the operative group. In accordance with standard DALY analyses, the nonoperative group is a hypothetical sample representative of the operative group had they not received surgery. Further description is provided in the article.

^c Total costs presented as a range with and without a 3% annual discount rate for years 2 and 3.

^d DALYs averted with surgery calculation: DALYs from nonoperative treatment minus the DALYs from operative treatment for a given scenario.

^e Incremental cost-effectiveness ratio score calculation: total cost of operative treatment minus the total cost of nonoperative treatment for a given scenario, divided by the DALYs averted of operative treatment minus DALYs averted for nonoperative treatment.