LETTER TO THE EDITOR REGARDING "HEALTH ECONOMIC EVALUATION OF MICROPROCESSOR AND NON-MICROPROCESSOR-CONTROLLED PROSTHETIC KNEES"
Bibliographic record
Abstract
This Letter to the Editor responds to the article by Bosman et al. ( https://doi.org/10.33137/cpoj.v8i2.45823 ). Real-world Dutch resource use data from Bosman et al. demonstrated lower non-prosthesis healthcare costs for microprocessor-controlled knee users compared with non-microprocessor-controlled knees, although the reported incremental cost per QALY (€457,063) appears unexpectedly high. This estimate likely overstates cost per QALY because prosthesis-related expenses were inconsistently prorated and implicitly assumed a 6-month replacement cycle, which is not clinically plausible. Recalculation assuming a conservative 5-year prosthesis replacement cycle resulted in an ICUR of €19,603 per QALY, consistent with accepted health technology assessment thresholds. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/46339/34632 How To Cite: Brüggenjürgen B, Riemer A, Gapp M. Letter to the editor regarding "Health economic evaluation of microprocessor and non-microprocessor-controlled prosthetic knees". Canadian Prosthetics & Orthotics Journal. 2025; Volume 8, Issue 2, No. 6. Https://doi.org/10.33137/cpoj.v8i2.46339 Corresponding Author: Prof. Dr. med. Bernd Brüggenjürgen, MPHAffiliation: Institute for Health Services Research and Technical Orthopedics, Orthopedic Department, Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Germany.E-Mail: Brueggenjuergen.Bernd@mh-hannover.deORCID ID: https://orcid.org/0000-0002-8866-0809
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".