The Agency for Healthcare Quality Research (AHRQ), in conjunction with a contractor known as an Evidence-based Practice Center, has released a draft systematic review of current scientific literature that address the use of lower limb prostheses in the United States. The Systematic review was originally announced in September of 2016 with a request for additional comments in December of 2016 on the “key questions” that would be used in the systematic review. AOPA provided significant comments on the systematic review itself as well as on the key questions issue.
While the complete systematic review document is 440 pages and is currently under review by AOPA, the abstract of the systematic review indicates the following:
- 92 studies were identified that assessed performance characteristics of lower limb prostheses
- 29 of the 92 studies were deemed valid and reliable by the researchers
- 19 of the 29 studies were generally applicable to Medicare aged populations
- 11-22% of amputees abandon their lower limb prosthesis within one year of delivery
- Unilateral trans-femoral amputees are twice as likely to abandon their prosthesis than unilateral trans-tibial amputees
- Currently, there is not evidence to support the selection of specific components for patient subgroups to maximize ambulation, function, and quality of life or to minimize abandonment or limited use
AOPA will be preparing extensive comments on the draft systematic review and encourages its members to review the document and provide comments as appropriate.