Critical Review of a Published Economic Evaluation - Economics Assignment

Internal Code: TV582

Critical Review of a Published Economic Evaluation

In this assessment you are expected to apply key steps you have learnt to critically review an economic evaluation (listed below). You need to address a number of issues applying a checklist which has been discussed during the lecture. You are required to use the checklist points to provide clear and concise answers for each of the checklist points. You should conclude with a statement (your opinion) on the overall quality of the published economic evaluation.

• Briffa T, et al. Cost-effectiveness of rehabilitation after an acute coronary event: a randomised controlled trial. MJA 2005; 183: 450–455

1. Has the study been identified as an economic evaluation (or more specific terms such as ‘‘cost-effectiveness analysis’’ have been used). • The interventions being compared?

2. Is there a well-defined question? • An explicit statement of the broader context for the study, including the economic importance of the research question • Clear objective or question? • Target population ((key characteristics),setting and location 3. Study perspective: • Has the perspective of the study been clearly stated? • Whether it is related to the costs being evaluated 4. Selection of alternative interventions? • Were alternative interventions described in sufficient details? • The rationale for the choice of the alternative interventions should be given 5. What is the time horizon of the study? • Is it appropriate given the condition under study? 6. Choice of outcome measure and valuation • What health outcomes were used as the measure(s) of benefit in the economic evaluation? Relevance to the type of economic evaluation? (e.g. Cost-utility analysis and QALYs) • (If applicable), were the methods and population used to elicit preferences presented in sufficient details? 7. Representation of clinical effectiveness • Data sources to estimate clinical effectiveness? • Were details (and justification) provided? • Were appropriate methods and data sources used to estimate clinical effectiveness? 8. Choice of health care resources and valuation • What resources were used for the economic evaluation? • Were all important and relevant items identified and included in the analysis? • Were appropriate methods and data sources used to accurately estimate appropriate physical units and unit costs? 9. Cost adjustment? (i.e. discounting, inflation, adjusting for international currencies) • Did the study provide details about the methods used? • Were the methods appropriate?    10. Modelling Details should be given of any modelling used in the economic study (e.g. decision analytic models, parametric models) • Choice of modelling technique (e.g. Markov model) and model structure (e.g. health states included) • Key inputs (e.g. transition probabilities) • Key assumptions (e.g. treatment effects beyond the duration of the trial, occurrence of rare side effects not observed during the trial) 11. Presentation and interpretation • Were mean values for the main categories of estimated costs and outcomes (e.g. HbA1c, QALYs) reported? • Were incremental figures reported? • Was the ICER reported? • Was the intervention cost-effective? 12. Characterising uncertainty • What statistical tests were performed? Were the confidence intervals around the key study variables reported? • Were sensitivity analyses conducted to characterise uncertainty in estimates of costs or outcomes? • Did the study provide details about the approach/approaches used (e.g. one-way sensitivity analysis) • Was justification given for the choice of parameters to vary and the range of values over which the parameters are varied? • Were the study results sensitive to changes in the values? 13. Discussion • Did the study provide the summary of key findings? (and how the findings support the conclusions reached) • Were the results compared with those of other studies that had investigated the same questions? • Did the study discuss key limitations of the findings? 14. Source of funding • Did the study describe how the study was funded and the role of the funder in the design, conduct, and reporting of the analysis?