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Abstract
Introduction: Evidence-based reviews in health care or public health have often lacked information on the economics of interventions. Published economic reviews have been largely limited to specific clinical interventions such as HIV or cancer prevention. Standardized instruments for translating economic data into comparable economic information do not exist. The Guide to Community Preventive Services has developed standardized methods and instruments for the systematic review of economic evaluations across a wide array of population-based health promotion and disease prevention interventions.
Objectives: This paper describes the methods used for systematically reviewing, abstracting and adjusting economic data of interventions included in the Guide and presents results from the first review.
Methods: The following steps are followed in conducting systematic reviews of economic evaluations: 1) Systematic searches are conducted; 2) studies using economic analytic methods such as cost analysis, cost-effectiveness, cost-benefit or cost-utility analysis are selected according to explicit inclusion criteria; 3) economic data are abstracted and adjusted using a standardized abstraction form; 4) adjusted costs, cost-savings, cost-effectiveness or cost-utility ratios are listed in economic evaluation summary tables. The economic evaluation abstraction form includes eight sections to track studies, compare interventions, identify summary measures, abstract descriptive information, and adjust summary measures for base-year, currency, costs, and health outcomes.
Results: These methods were successfully used in a review of ten interventions to improve vaccine coverage in children, adolescents, and adults. Average cost and cost-effectiveness data from 24 studies were abstracted and adjusted. Ten average costs and fourteen cost-effectiveness ratios were expressed in 1997 US$. Great variability was observed regarding type of costs included in the analysis and intervention definition. Gaps in data were found for many interventions.
Discussion: The methods and instruments developed by the Guide provide an explicit and systematic approach for abstracting economic evaluation data. They will reduce methodological differences, improve study quality, and increase usefulness of economic information for informed policy-making in health care and public health.
Objectives: This paper describes the methods used for systematically reviewing, abstracting and adjusting economic data of interventions included in the Guide and presents results from the first review.
Methods: The following steps are followed in conducting systematic reviews of economic evaluations: 1) Systematic searches are conducted; 2) studies using economic analytic methods such as cost analysis, cost-effectiveness, cost-benefit or cost-utility analysis are selected according to explicit inclusion criteria; 3) economic data are abstracted and adjusted using a standardized abstraction form; 4) adjusted costs, cost-savings, cost-effectiveness or cost-utility ratios are listed in economic evaluation summary tables. The economic evaluation abstraction form includes eight sections to track studies, compare interventions, identify summary measures, abstract descriptive information, and adjust summary measures for base-year, currency, costs, and health outcomes.
Results: These methods were successfully used in a review of ten interventions to improve vaccine coverage in children, adolescents, and adults. Average cost and cost-effectiveness data from 24 studies were abstracted and adjusted. Ten average costs and fourteen cost-effectiveness ratios were expressed in 1997 US$. Great variability was observed regarding type of costs included in the analysis and intervention definition. Gaps in data were found for many interventions.
Discussion: The methods and instruments developed by the Guide provide an explicit and systematic approach for abstracting economic evaluation data. They will reduce methodological differences, improve study quality, and increase usefulness of economic information for informed policy-making in health care and public health.