Misinterpreted Markov analysis

In a recent article, Overley et al. [1] used a Markov analysis to report on the 5-year cost-effectiveness of two-level anterior cervical discectomy and fusion (ACDF) versus cervical disc replacement (CDR) as treatment to cervical degenerative disc disease (DDD). I will not challenge the numerical results as presented, but rather the three main conclusions derived from the results. One cherry-picks a willingness-to-pay (WTP) threshold, one misunderstands the underlying data, and the third misrepresents a statistical procedure.

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