Conducting systematic reviews of economic evaluations
Conducting systematic reviews of economic evaluations
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DOI：
10.1097/xeb.0000000000000063
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发表时间：
2015-09-01
影响因子：
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通讯作者：
Preda, Alin
中科院分区：
文献类型：
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作者：
Gomersall, Judith Streak;Jadotte, Yuri Tertilus;Preda, Alin
背景：在2012年，成立了一个工作组，以审查和加强乔安娜布里格斯研究所（JBI）的指导进行系统审查的证据，从经济评价解决一个问题（S）关于健康干预的成本效益。Objectives：目标是要提出的工作组的成果。Methods：该小组进行了三项活动，以通知新的指导：审查文献的效用/徒劳的系统审查的经济评价和审议其影响更新现有的方法;对照促进经济评价研究有效性的标准和另外两个常用工具，评估现有指导中的关键评价工具;以及一次讲习班。文献中关于经济学证据系统性综述的局限性/价值的争论警告说，经济学评价证据的系统性综述不太可能对成本问题产生一刀切的答案。干预措施及其比较措施的有效性。根据这一调查结果，工作组调整了现有联合执行倡议方法中目标定义的框架。这种转变是从确定一种成本-效果指标的目标定义转向总结成本-效果的研究估计值，并通过考虑纳入的研究特征（患者、环境、干预成分等）提供信息，确定有利于降低成本和最大限度地提高健康效益的条件。现有的关键评价工具已纳入新的指导意见。新的指导意见包括一项建议，即专门为评价基于模型的研究而设计的工具应与经济评价评估的通用评价工具一起使用，以评价基于模型的评价。该小组制定的指南为系统评价过程的每一步提供了指导，这些步骤与JBI对其他类型证据的评价步骤相同。讨论：更新后的JBI指南将有助于研究人员综合经济问题的证据，无论是作为独立的评价还是综合或混合方法证据评价的一部分。虽然工作组工作产生的最新方法改进了联合执行机构关于系统审查经济评价的指导意见，但仍有一些领域需要进一步开展工作。这些措施包括调整关键评估工具，将涉及干预成本和效果衡量的问题分离出来;为评估结果的普遍性提供更明确的指导;提供更有力的证据综合方法，以促进实现更雄心勃勃的审查目标。
Background:In 2012, a working group was established to review and enhance the Joanna Briggs Institute (JBI) guidance for conducting systematic review of evidence from economic evaluations addressing a question(s) about health intervention cost-effectiveness.Objectives:The objective is to present the outcomes of the working group.Methods:The group conducted three activities to inform the new guidance: review of literature on the utility/futility of systematic reviews of economic evaluations and consideration of its implications for updating the existing methodology; assessment of the critical appraisal tool in the existing guidance against criteria that promotes validity in economic evaluation research and two other commonly used tools; and a workshop.Results:The debate in the literature on the limitations/value of systematic review of economic evidence cautions that systematic reviews of economic evaluation evidence are unlikely to generate one size fits all answers to questions about the cost-effectiveness of interventions and their comparators. Informed by this finding, the working group adjusted the framing of the objectives definition in the existing JBI methodology. The shift is away from defining the objective as to determine one cost-effectiveness measure toward summarizing study estimates of cost-effectiveness and informed by consideration of the included study characteristics (patient, setting, intervention component, etc.), identifying conditions conducive to lowering costs and maximizing health benefits. The existing critical appraisal tool was included in the new guidance. The new guidance includes the recommendation that a tool designed specifically for the purpose of appraising model-based studies be used together with the generic appraisal tool for economic evaluations assessment to evaluate model-based evaluations. The guidance produced by the group offers reviewers guidance for each step of the systematic review process, which are the same steps followed in JBI reviews of other types of evidence.Discussion:The updated JBI guidance will be useful for researchers wanting to synthesize evidence about economic questions, either as stand-alone reviews or part of comprehensive or mixed method evidence reviews. Although the updated methodology produced by the work of the working group has improved the JBI guidance for systematic reviews of economic evaluations, there are areas where further work is required. These include adjusting the critical appraisal tool to separate out questions addressing intervention cost and effectiveness measurement; providing more explicit guidance for assessing generalizability of findings; and offering a more robust method for evidence synthesis that facilitates achieving the more ambitious review objectives.