Evidence mapPaperPMID 42178151Full record

ArticleInternational wound journal2026

An Early Trial-Based Cost-Effectiveness Analysis of Extracorporeal Shockwave Therapy for Diabetes Related Foot Ulcer Healing.

L Hitchman, M Siciliano, R Lathan, B Ravindhran, M Sidapra, J Long, G Smith, M Twiddy, D Russell, I C Chetter and 1 more

Abstract read
In one paragraph

Article in International wound journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

L HitchmanFaculty of Clinical Sciences, Hull York Medical School, Hull, UK.
M SicilianoDepartment of Health Sciences, University of York, York, UK.
R LathanFaculty of Clinical Sciences, Hull York Medical School, Hull, UK.
B RavindhranFaculty of Clinical Sciences, Hull York Medical School, Hull, UK.
M SidapraFaculty of Clinical Sciences, Hull York Medical School, Hull, UK.
J LongHull University Teaching Hospitals NHS Trust, Hull, UK.
G SmithFaculty of Clinical Sciences, Hull York Medical School, Hull, UK.
M TwiddyInstitute of Clinical and Applied Health Research, Hull York Medical School, Hull, UK.
D RussellLeeds Vascular Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
I C ChetterFaculty of Clinical Sciences, Hull York Medical School, Hull, UK.
C Iglesias UrrutiaDepartment of Health Sciences, University of York, York, UK.

Funding

National Institute for Health and Care Research NIHR301807
6 · The paper itself

Abstract

Diabetes related foot ulcers (DFUs) cause significant morbidity and mortality. Extracorporeal shockwave therapy (ESWT) is a promising adjunct to promote healing. This study aimed to explore the potential cost-effectiveness of ESWT in DFU healing. Early model-based cost-effectiveness analysis was undertaken. A de novo four-state, 1-day cycle, Markov model was developed. The perspective for the analysis was the UK's National Health Service (NHS) and Personal Social Services over a 1-year time horizon. Input parameters were estimated from the literature. Low dose ESWT, high dose ESWT and standard care alone were evaluated by running a simulation of 1000 patients with one DFU. Deterministic, probabilistic and value of information analysis were undertaken. Deterministic analysis indicated high dose ESWT has the potential to be a dominant strategy (i.e., no incremental analysis was necessary), exhibiting higher QALYs and lower costs compared to low dose ESWT and standard care. The mean difference in QALYs and costs between high dose ESWT and standard care were 0.022 QALYs and a £922 cost reduction. Preliminary probabilistic analysis, using a threshold of £20 000 per QALY, estimated a 60.2% probability of high dose ESWT being cost-effective compared to standard care. The value of eliminating uncertainty in the model (EVPI) was estimated at £24.56 per patient, with high dose efficacy (partial EVPI per patient £7.87) and health-related quality of life (HRQoL) scores (partial EVPI per patient £3.56) identified as specific areas for future research. This study suggests that ESWT could be a dominant adjunct to aid DFU healing. A definitive study is warranted to estimate ESWT's effectiveness and related HRQoL scores.

Indexed as

Cost-Benefit AnalysisCost-Effectiveness AnalysisDiabetic FootExtracorporeal Shockwave TherapyWound HealingAdultAgedFemaleHumansMaleMiddle AgedTreatment OutcomeUnited Kingdomcost‐effectivenessdiabetic foot ulcerseconomic evaluationextracorporeal shockwave therapywound healing

Identifiers

PMID42178151
PMCPMC13240492

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.