Article type
Year
Abstract
Background:
Urinary incontinence (UI) is an involuntary loss of urine and it is a common problem, with a reported prevalence between 25% and 45%. Prevalence is higher among women with the risks of UI increasing with age. Though the condition is not life threatening, it is life limiting.
Objectives:
The aim is to develop an evidence gap map of economic evaluations of UI interventions to facilitate the incorporation of economic evidence into Cochrane Incontinence reviews. It is unclear how extensive the economic evaluations are; the types of interventions compared in terms of costs and effects, and the context and settings of these studies. An evidence gap map will give a broad picture of the “breadth, depth and methodology” of the economic evaluations of the management of UI.
Methods:
Systematic searches for full economic evaluations related to UI were performed in NHS EED (inception to 31 December 2014), MEDLINE (1946 to June Week 2 2019) and Embase (1974 to 2019 Week 23) on 14 June 2019. No language restrictions were applied. No restrictions were made with respect to population and type of intervention. Two reviewers independently screened studies and any conflicts were resolved. Data on type of: UI; intervention; economic evaluation; outcome measures as well as funding and data sources, were extracted and double-checked by a second reviewer. A dot plot mapping the four main intervention categories, health outcomes and the funding source was constructed.
Results:
The literature search produced 2193 unique records. After two rounds of title and abstract screening, first based on our economic evaluation definition (1770 excluded) and then on our UI definition (220 excluded), 203 records remained for full-text screening of which 110 were included. The majority of the studies came from Europe or North America (n=91) or were unclear (n=12); none included children, 52 included only women and 5 included only men.
The evidence gap map suggests that more economic evaluations are available for drug and surgical interventions (over 50% of these studies were commercially funded) than conservative measures (Figure 1). Only one study compared the costs and effectiveness of the three main types of interventions.
Conclusions:
For urinary incontinence, the evidence base on cost-effectiveness upon which Cochrane reviews can draw is limited. The evidence gap map highlights important gaps for future rigorous studies; it is also a data source, which can streamline searching for economic evidence.
Patient or healthcare consumer involvement:
There was no direct patient involvement. However, the identified evidence and gaps could lead to better targeting and uses of limited health resources that will benefit patients. Rigorous economic evaluations based on reliable data sources is crucial in improving both physical and subjective welling of patients.
Urinary incontinence (UI) is an involuntary loss of urine and it is a common problem, with a reported prevalence between 25% and 45%. Prevalence is higher among women with the risks of UI increasing with age. Though the condition is not life threatening, it is life limiting.
Objectives:
The aim is to develop an evidence gap map of economic evaluations of UI interventions to facilitate the incorporation of economic evidence into Cochrane Incontinence reviews. It is unclear how extensive the economic evaluations are; the types of interventions compared in terms of costs and effects, and the context and settings of these studies. An evidence gap map will give a broad picture of the “breadth, depth and methodology” of the economic evaluations of the management of UI.
Methods:
Systematic searches for full economic evaluations related to UI were performed in NHS EED (inception to 31 December 2014), MEDLINE (1946 to June Week 2 2019) and Embase (1974 to 2019 Week 23) on 14 June 2019. No language restrictions were applied. No restrictions were made with respect to population and type of intervention. Two reviewers independently screened studies and any conflicts were resolved. Data on type of: UI; intervention; economic evaluation; outcome measures as well as funding and data sources, were extracted and double-checked by a second reviewer. A dot plot mapping the four main intervention categories, health outcomes and the funding source was constructed.
Results:
The literature search produced 2193 unique records. After two rounds of title and abstract screening, first based on our economic evaluation definition (1770 excluded) and then on our UI definition (220 excluded), 203 records remained for full-text screening of which 110 were included. The majority of the studies came from Europe or North America (n=91) or were unclear (n=12); none included children, 52 included only women and 5 included only men.
The evidence gap map suggests that more economic evaluations are available for drug and surgical interventions (over 50% of these studies were commercially funded) than conservative measures (Figure 1). Only one study compared the costs and effectiveness of the three main types of interventions.
Conclusions:
For urinary incontinence, the evidence base on cost-effectiveness upon which Cochrane reviews can draw is limited. The evidence gap map highlights important gaps for future rigorous studies; it is also a data source, which can streamline searching for economic evidence.
Patient or healthcare consumer involvement:
There was no direct patient involvement. However, the identified evidence and gaps could lead to better targeting and uses of limited health resources that will benefit patients. Rigorous economic evaluations based on reliable data sources is crucial in improving both physical and subjective welling of patients.