Futility to utility: improving synthesis methods for systematic reviews of economic evaluations

Abstract text
Background: There is growing recognition that current synthesis methods used in systematic reviews of economic evaluations lack utility in informing funding decisions at a local level. Narrative synthesis is most commonly employed; however the information is seldom presented for a specific decision context. Reviews infrequently attempt to identify differences in resource use or costs across jurisdictions. In addition, quality of data sources is rarely reported, impeding the assessment of the validity and reliability of individual study results. These inadequacies make comparisons of economic evaluations across jurisdictions a futile exercise. In spite of this apparent futility, hundreds of reviews continue to be published each year. Indeed some health technology appraisal agencies require submission of these reviews for assessment.

Objectives: To present three methods for systematic reviews of economic evaluations of health technologies that will improve knowledge translation and assist in evidence based decision-making.

Methods/Results: Three methods that build on existing ideas in the literature are presented to address the inadequacies discussed above. Firstly a proposed hierarchy of evidence for data inputs used in decision modeling was developed to increase trustworthiness of individual study results. The second method uses meta-analytic techniques to pool resource use and cost data included in decision models in order to identify heterogeneity and jurisdiction specific economic impacts. Finally, a presentation method that frames information in a decision context and relies on colour-coding, symbols and bullet points was developed. This method provides a high-level summary of key information required by decision makers to derive reliable conclusions about cost-effectiveness from a heterogeneous group of studies.

Conclusions: The proposed methods aim to improve the local understanding and usefulness of existing cost-effectiveness evidence from systematic reviews of the literature. It is hoped that uptake of these methods by researchers will convert an exercise in futility into one of utility.
Doble B1, Harris A1, Lorgelly P1
1 Centre for Health Economics, Monash University, Australia
Presenting author and contact person
Presenting author: 
Brett Doble
Contact person Affiliation Country
Brett Doble (Contact this person) Centre for Health Economics, Monash University Australia
Date and Location
Oral session C14O3
Wednesday 3 October 2012 - 11:40 - 12:00