How to prepare a systematic review of economic evaluations for informing evidence-based healthcare decisions: a five-step approach (part 1/3)

Abstract

Introduction: Systematic reviews of economic evaluations are useful for synthesizing economic evidence about health interventions and for informing evidence-based decisions. Areas covered: As there is no detailed description of the methods for performing a systematic review of economic evidence, this paper aims to provide an overview of state-of-the-art methodology. This is laid out in a 5-step approach, as follows: step 1) initiating a systematic review; step 2) identifying (full) economic evaluations; step 3) data extraction, risk of bias and transferability assessment; step 4) reporting results; step 5) discussion and interpretation of findings. Expert commentary: The paper aims to help inexperienced reviewers and clinical practice guideline developers, but also to be a resource for experts in the field who want to check on current methodological developments. ARTICLE HISTORY

Evidence in Medicine: Math Versus Biology!

“…Conversely, a properly conducted systematic review of multiple economic analyses would often represent the highest level of economic evidence. Other approaches for the critical appraisal of model-based evidence are also available, including scoring systems for economic analyses 8 and guidelines for good modelling practices 5 and for the conduct of systematic reviews for economic evaluations 9 . Evidence in medicine that is based on mathematical modelling therefore varies with respect to its strengths and should affect clinical decisions only accordingly.…”

How to prepare a systematic review of economic evaluations for informing evidence-based healthcare decisions: data extraction, risk of bias, and transferability (part 3/3)

“…In this article, which focuses on Step 3 of the overall framework (see Figure 1 [1]), attention will be paid to data extraction, risk of bias assessment, and transferability when preparing a systematic literature review of economic evaluations (SR-EEs). Moreover, the article is also perfectly readable as a stand-alone read.…”

“…The term 'full EE' refers to the comparative analysis of alternative courses of action in terms of both costs (resource use) and consequences (outcomes and effects) [5]. Basically, there are two approaches to performing an EE study [7]: (1) an EE which is piggy-backed onto a clinical effectiveness study (e.g. a randomized controlled trial or observational study), often called a trial-based EE; and (2) a model-based EE, in which data from a wide range of sources (randomized controlled trials, observational studies, trial-based EEs, and other literature or reports) are combined using an economic model.…”

“…SR-EEs can be categorized roughly into three groups: (1) multipurpose reviews, (2) reviews for informing the development of CPGs, and (3) reviews for developing decision analytic models. Both multipurpose SR-EEs and SREEs for guideline development aim to synthesize and critically appraise existing EEs of a health-care intervention or disease area in order to inform policy decisions [1,14]. The guidance in this article covers only the first two types of SR categories.…”

Health technology assessment in epilepsy

“…Though recommended, economic evaluations (EEs) are not routinely incorporated in clinical practice guidelines. 87 Studies investigating the uptake of HTA-studies in clinical practice found that this is generally limited, especially at the local level. 88,89 Until 2014, economic evidence was not incorporated into the Dutch clinical practice guidelines, which were based on scientific research (clinical trials) supplemented by the expertise of health care professionals and patients.…”