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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.063 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.026 | 0.023 |
| Insufficient payload (model declined to judge) | 0.009 | 0.007 |
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 source (direct Gemma or distilled Codex), 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".