Article type
Year
Abstract
Background:
Patients, clinicians, policymakers and other stakeholders face numerous challenges in healthcare decision-making, including the greater complexity of healthcare systems and policies, the increasing global burden of chronic diseases, and the worldwide reality of dwindling healthcare resources. These are only some of the major problems for which critically appraised and readily available synthesized evidence, using different methodological perspectives, continues to be urgently needed. This then requires the pooling of evidence beyond just the effectiveness of interventions or diagnostic tests, but also on their appropriateness, meaningfulness, feasibility, and equity. The Cochrane Collaboration and other worldwide evidence synthesis bodies are increasingly encouraging the systematic review of qualitative evidence to address the appropriateness and meaningfulness perspectives. Yet systematic reviews of primary economic evaluation studies remain rare, even though they can provide invaluable insights on feasibility and equity. This is primarily due to the critique that the contextual nature of economic evidence precludes usable evidence synthesis.
Objectives:
The objective of this project is to demonstrate the use and usefulness of systematic review methodology and hierarchical decision matrices to evaluate evidence of efficiency from primary economic studies on healthcare interventions.
Methods:
A systematic review of primary economic evaluation studies on the cost effectiveness of Mohs micrographic surgery for non-melanoma skin cancer was conducted, based on an a priori published protocol, as a demonstration project of the synthesis of economic evidence. Hierarchical decision matrices were created as a method to pool evidence of efficiency.
Results:
This study demonstrates that hierarchical decision matrices can be useful in synthesizing evidence of efficiency.
Conclusions:
In an era of increasing disease burden and healthcare costs, evaluating methods for pooling primary economic evaluation studies is imperative in order to improve healthcare decision-making at the clinician/patient level, and healthcare equity at policy level.
Patients, clinicians, policymakers and other stakeholders face numerous challenges in healthcare decision-making, including the greater complexity of healthcare systems and policies, the increasing global burden of chronic diseases, and the worldwide reality of dwindling healthcare resources. These are only some of the major problems for which critically appraised and readily available synthesized evidence, using different methodological perspectives, continues to be urgently needed. This then requires the pooling of evidence beyond just the effectiveness of interventions or diagnostic tests, but also on their appropriateness, meaningfulness, feasibility, and equity. The Cochrane Collaboration and other worldwide evidence synthesis bodies are increasingly encouraging the systematic review of qualitative evidence to address the appropriateness and meaningfulness perspectives. Yet systematic reviews of primary economic evaluation studies remain rare, even though they can provide invaluable insights on feasibility and equity. This is primarily due to the critique that the contextual nature of economic evidence precludes usable evidence synthesis.
Objectives:
The objective of this project is to demonstrate the use and usefulness of systematic review methodology and hierarchical decision matrices to evaluate evidence of efficiency from primary economic studies on healthcare interventions.
Methods:
A systematic review of primary economic evaluation studies on the cost effectiveness of Mohs micrographic surgery for non-melanoma skin cancer was conducted, based on an a priori published protocol, as a demonstration project of the synthesis of economic evidence. Hierarchical decision matrices were created as a method to pool evidence of efficiency.
Results:
This study demonstrates that hierarchical decision matrices can be useful in synthesizing evidence of efficiency.
Conclusions:
In an era of increasing disease burden and healthcare costs, evaluating methods for pooling primary economic evaluation studies is imperative in order to improve healthcare decision-making at the clinician/patient level, and healthcare equity at policy level.