Article type
Year
Abstract
Background: Many reports undertaken at the Canadian Coordinating Office for Health Technology Assessment (CCOHTA) include a review of economic evidence. It is important that these economic reviews be done in a systematic manner in order to minimize bias.
Objective: To develop a section for CCOHTA's update to "Guidelines for Economic Evaluation of Pharmaceuticals: Canada" that will assist researchers in reviewing existing economic evidence for pharmaceuticals, medical devices, and systems.
Methods: The general approach is to take techniques developed for the systematic review of clinical evidence, and where feasible give guidance for their application to reviews of economic evidence of health technologies.
Results: At a minimum, the following elements should be contained in a systematic review of existing economic evidence. - A clear study question. - A protocol including a clear explanation of: Target patient population Intervention of interest Comparators Outcomes of interest Economic study designs considered. - A comprehensive literature search carried out by a qualified IS professional. - Predetermined eligibility criteria for included studies. - A predetermined data extraction form. - Two reviewers to independently select studies and extract data. - A "QUOROM style" flow chart outlining the management of potentially relevant citations. - A table for systematic presentation of characteristics of included studies. - A table for systematic presentation of study results. - An assessment of the quality of included economic studies.
Conclusions: Application to economic evidence of approaches used for the systematic review of clinical evidence can aid in clearer and more standardized reporting of that evidence. Not all techniques from clinical systematic review currently lend themselves to economic reviews (for example, the assessment of publication bias and quantitative meta-analysis). These present possible areas for future methodological research.
References: 1. Moher D, Pham B, Klassen TP, Schulz KF, Berlin JA, Jadad AR, et al. What contributions do languages other than English make on the results of meta-analyses? J Clin Epidemiol. 2000;53(9):964-72. 2. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet. 1999;354(9193):1896-900. 3. Drummond MF, Jefferson TO; BMJ Economic Evaluation Working Party. Guidelines for authors and peer reviewers of economic submissions to the BMJ. BMJ. 1996;313(7052):275-83. Available from: http://www.bmj.com/cgi/content/full/313/7052/275. 4. Jefferson T, Mugford M, Gray A, Demicheli V. An exercise on the feasibility of carrying out secondary economic analyses. Health Econ 1996;5(2):155-65. 5. Jefferson T, Demicheli V. Methodological quality of economic modelling studies. A case study with hepatitis B vaccines. Pharmacoeconomics 1998;14(3):251-7. 6. Mugford M. Using systematic reviews for economic evaluation. In: Egger M, Smith GD, Altman DG, editors. Systematic reviews in health care: meta-analysis in context. 2nd ed. London: BMJ Publishing Group; 2001. p.419-28. 7. Canadian Coordinating Office for Health Technology Assessment. Guidelines for economic evaluation of pharmaceuticals: Canada. 2nd ed. Ottawa: The Office; 1997.
Objective: To develop a section for CCOHTA's update to "Guidelines for Economic Evaluation of Pharmaceuticals: Canada" that will assist researchers in reviewing existing economic evidence for pharmaceuticals, medical devices, and systems.
Methods: The general approach is to take techniques developed for the systematic review of clinical evidence, and where feasible give guidance for their application to reviews of economic evidence of health technologies.
Results: At a minimum, the following elements should be contained in a systematic review of existing economic evidence. - A clear study question. - A protocol including a clear explanation of: Target patient population Intervention of interest Comparators Outcomes of interest Economic study designs considered. - A comprehensive literature search carried out by a qualified IS professional. - Predetermined eligibility criteria for included studies. - A predetermined data extraction form. - Two reviewers to independently select studies and extract data. - A "QUOROM style" flow chart outlining the management of potentially relevant citations. - A table for systematic presentation of characteristics of included studies. - A table for systematic presentation of study results. - An assessment of the quality of included economic studies.
Conclusions: Application to economic evidence of approaches used for the systematic review of clinical evidence can aid in clearer and more standardized reporting of that evidence. Not all techniques from clinical systematic review currently lend themselves to economic reviews (for example, the assessment of publication bias and quantitative meta-analysis). These present possible areas for future methodological research.
References: 1. Moher D, Pham B, Klassen TP, Schulz KF, Berlin JA, Jadad AR, et al. What contributions do languages other than English make on the results of meta-analyses? J Clin Epidemiol. 2000;53(9):964-72. 2. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet. 1999;354(9193):1896-900. 3. Drummond MF, Jefferson TO; BMJ Economic Evaluation Working Party. Guidelines for authors and peer reviewers of economic submissions to the BMJ. BMJ. 1996;313(7052):275-83. Available from: http://www.bmj.com/cgi/content/full/313/7052/275. 4. Jefferson T, Mugford M, Gray A, Demicheli V. An exercise on the feasibility of carrying out secondary economic analyses. Health Econ 1996;5(2):155-65. 5. Jefferson T, Demicheli V. Methodological quality of economic modelling studies. A case study with hepatitis B vaccines. Pharmacoeconomics 1998;14(3):251-7. 6. Mugford M. Using systematic reviews for economic evaluation. In: Egger M, Smith GD, Altman DG, editors. Systematic reviews in health care: meta-analysis in context. 2nd ed. London: BMJ Publishing Group; 2001. p.419-28. 7. Canadian Coordinating Office for Health Technology Assessment. Guidelines for economic evaluation of pharmaceuticals: Canada. 2nd ed. Ottawa: The Office; 1997.