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TRANSTIBIAL ECONOMIC EVALUATIONS 89

Figure 1. Flow diagram.
Articles identified through database searching:
Identification PubMed, CINAHL, Google Scholar Articles Eliminated
(n=292)
Stage 1 Screening
Articles potentially avaialble (n=263)
Screening (n=29) Articles Eliminated
for classification of pertinence

Stage 2 Screening
(n=23)
Eligibility for Soring & Evaluation
Articles deemed appropriate
(n=6)

Included Care Models Treatment (n=2) Prosthetic Sockets
Prosthetic
(n=1)
(n=3)

and whether the contributing findings were confir- these, only two of the studies were funded, one by
matory or conflicting as similarly outlined by others multiple sources (professional association, govern-
(21). mental, educational) (23) and the other by an insurer
(26).
RESULTS
Study Demographics, Interventions, and
Literature Search Outcome Measures
The search yielded 292 manuscripts (Figure 1).
Stage 1 screening eliminated 263 manuscripts and Articles in this review included a total of 704
stage 2 screening an additional 23 manuscripts, leav- patients. Among them, 460 were undergoing limb
ing six articles meeting eligibility criteria. The six salvage, whereas the remaining 244 had TTA of mixed
remaining articles, published from 2004 to 2011, etiology. The median (range) sample size was n =
were divided into the following three topical areas: 43 (20 to 484). See Table 1 for extracted study data,
including specific characteristics of the subjects and
1. Care Models (n = 1) (22) studies. The reviewed studies were classified into
2. Prosthetic Treatment (n = 2) (23,24) three of the 15 potential study designs (controlled
3. Prosthetic Sockets (n = 3) (25-27) trial, randomized controlled trial, and case-con-
Three of the articles were published in Prosthetics and trol designs) described by the AAOP Study Design
Orthotics International. The remaining three papers Classification Scale (20). All three of the socket manu-
were published in other journals. From an economic scripts represented experimental study designs, while
evaluation type, all six papers were trial-design (as the remaining three utilized observational designs.
opposed to modeling). Five were cost-consequence Clinical outcome measures reported in the reviewed
evaluations and one was a cost-identification design publications included duration of care, perceived
(Table 1). function, prosthetic satisfaction, clinical gait out-
comes, time to prosthetic delivery, and number of
Funding visits. Economic outcomes reported in the reviewed
Four of the six manuscripts included a statement publications included cost of prosthetic fabrica-
disclosing whether or not the study was funded. Of tion, prosthetic maintenance, prosthetic provision,