Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-10T14:02:14.359Z Has data issue: false hasContentIssue false
  • English
  • Français

Quality appraisal of pediatric health economic evaluations

Published online by Cambridge University Press:  26 April 2005

Wendy J. Ungar  and
Maria T. Santos
Wendy J. Ungar
Affiliation:
University of Toronto and The Hospital for Sick Children
Maria T. Santos
Affiliation:
The Hospital for Sick Children
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: This study was undertaken to appraise the quality of published pediatric economic evaluations.

Methods: Two independent reviewers appraised 149 randomly selected pediatric health economic studies. Data were collected from full economic evaluations published between 1980 and 1999. Economic evaluations of interventions, programs, and services aimed at neonates to adolescents were included. The Pediatric Quality Appraisal Questionnaire (PQAQ) was used for appraisal. The PQAQ is a 57-item instrument with 13 domains scored from 0 to 1 and one descriptive domain, each corresponding to a key aspect of health economic methodology. The primary outcome was the score for each domain. Additional analyses examined the global rating, the distribution of analytic technique, and the association between domain score and analytic technique.

Results: A total of 38 percent of publications were very good to excellent, whereas 43 percent were fair or worse. Although the Discounting, Target Population, Economic Evaluation, Conclusions, and Comparators domains exhibited good quality (0.74 to 0.78), the papers were of poor quality for Conflict of Interest, Incremental Analysis, and Perspective (0.32 to 0.39). Analytic technique was a significant predictor of quality for study design-related domains, with cost-utility analyses demonstrating the highest domain scores.

Conclusions: Domains closely related to the elements of economic evaluation demonstrated medium to high quality. However, domains related to analysis fared poorly and are worthy of further methodological research to improve the use of health economic methods in children.

Keywords

Quality appraisalEconomic evaluationCost-effectiveness analysisPediatrics
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 2 , April 2005 , pp. 203 - 210
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams ME, McCall NT, Gray DT, Orza MJ, Chalmers TC. 1992 Economic analysis in randomized control trials. Med Care. 30: 231– 243.Google Scholar
Anell A, Norinder A. 2000 Health outcome measures used in cost-effectiveness studies: A review of original articles published between 1986 and 1996. Health Policy. 51: 87– 99.Google Scholar
Blackmore CC, Magid DJ. 1997 Methodologic evaluation of the radiology cost-effectiveness literature. Radiology. 203: 87– 91.Google Scholar
Bradley CA, Iskedjian M, Lanctot KL, et al. 1995 Quality assessment of economic evaluations in selected pharmacy, medical, and health economics journals. Ann Pharmacother. 29: 681– 689.Google Scholar
Briggs A, Sculpher M. 1995 Sensitivity analysis in economic evaluation: A review of published studies. Health Econ. 4: 355– 371.Google Scholar
Bronfenbrenner U, Moen P, Garbarino J. Families and communities. In: Parke HR, ed. 1984. Review of child development research. Chicago: University of Chicago Press;
Canadian Coordinating Office for Health Technology Assessment. 2002. Guidelines for the economic evaluation of pharmaceuticals: Canada. 2nd ed. Ottawa, ON: Canadian Coordinating Office for Health Technology Assessment; 1997. Available at: http://www.ccohta.ca/ccohta_production/entry_e.html. Accessed: September 6
Drummond MF, O'Brien B, Stoddart GL, Torrance GW. 1997. Methods for the economic evaluation of health care programs. 2nd ed. Toronto, ON: Oxford University Press;
Elixhauser A, Halpern M, Schmier J, Luce BR. 1998 Health care CBA and CEA from 1991 to 1996: an updated bibliography. Med Care. 36 (Suppl): MS1– MS9, MS18-MS147.Google Scholar
Elixhauser A, Luce BR, Taylor WR, Reblando J. 1993 Health care CBA/CEA: An update on the growth and composition of the literature. Med Care. 31 (Suppl): JS1– JS11, JS18-JS149.Google Scholar
Evidence-Based Medicine Working Group (Canada). 2002. Worksheet for using an article about an economic analysis. Edmonton, AB: The Evidence-Based Medicine Working Group, University of Alberta; 2000. Available at: http://www.med. ualberta.ca/ebm/econ.htm. Accessed: September 6
Ganiats TG, Wong AF. 1991 Evaluation of cost-effectiveness research: A survey of recent publications. Fam Med. 23: 457– 462.Google Scholar
Gerard K, Seymour J, Smoker I. 2000 A tool to improve quality of reporting published economic analyses. Int J Technol Assess Health Care. 16: 100– 110.Google Scholar
Gerard K. 1992 Cost-utility in practice: A policy maker's guide to the state of the art. Health Policy. 21: 249– 279.Google Scholar
Halfon N, Newacheck PW. 2000. Characterizing the social impact of asthma in children. In: Weiss KB, Buist AS, Sullivan SD, eds. Asthma's impact on society, the social and economic burden. New York, NY: Marcel Dekker Inc;
Practice Management Information Corporation. 1998. ICD-9-CM: International Classification of Diseases, 9th revision: clinical modification. 5th ed. Los Angeles, CA: Practice Management Information Corporation;
Iskedjian M, Trakas K, Bradley CA, et al. 1997 Quality assessment of economic evaluations published in Pharmacoeconomics. The first four years (1992 to 1995). Pharmacoeconomics. 12: 685– 694.Google Scholar
Jacobs J, Bachynsky J, Baladi J. 1995 A comparative review of pharmacoecomomic guidelines. Pharmacoeconomics. 8: 182– 189.Google Scholar
Jameson EJ, Wehr E. 1993 Drafting national health reform legislation to protect the health interests of children. Stanford Law Policy Rev. Fall 152– 176.Google Scholar
Lee JT, Sanchez LA. 1991 Interpretation of “cost-effective” and soundness of economic evaluations in the pharmacy literature. Am J Hosp Pharm. 48: 2622– 2627.Google Scholar
Perrin JM. 1985. Introduction. In: Hobbs N, Perrin MJ, eds. Issues in the care of children with chronic illness. San Francisco: Jossey-Bass Publishers Inc;
Pritchard C. 1998. Trends in economic evaluation. London, UK: Office of Health Economics; OHE Briefing No. 36.
Sacristan JA, Soto J, Galende I. 1993 Evaluation of pharmacoeconomic studies: Utilization of a checklist. Ann Pharmacother. 27: 1126– 1133.Google Scholar
SAS Institute. 1999. SAS system for Windows [computer program].Version 8.02. Cary, NC: SAS Institute;
Siegel JE, Weinstein MC, Russell LB, Gold MR. 1996 Recommendations for reporting cost-effectiveness analyses. Panel on Cost-Effectiveness in Health and Medicine. JAMA. 276: 1339– 1341.Google Scholar
Starfield B, Newacheck P. Children's health status, health risks and use of health services. In: Schlesinger MJ, Eisenberg L, eds. 1990. Children in a changing health system: Assessments and proposals for reform. Baltimore, MD: Johns Hopkins University Press;
Torrance G, Blaker D, Detsky A, et al. 1996 Canadian guidelines for economic evaluation of pharmaceuticals. Pharmacoeconomics. 9: 535– 559.Google Scholar
Trakas K, Addis A, Kruk D, Buczek Y, Iskedjian M, Einarson TR. 1997 Quality assessment of pharmacoeconomic abstracts of original research articles in selected journals. Ann Pharmacother. 31: 423– 428.Google Scholar
Udvarhelyi IS, Colditz GA, Rai A, Epstein AM. 1992 Cost-effectiveness and cost-benefit analyses in the medical literature. Are the methods being used correctly? Ann Intern Med. 116: 238– 244.Google Scholar
Ungar W, Santos M. 2002. The Pediatric Economic Database Evaluation (PEDE) project. Ottawa ON: Canadian Coordinating Office for Health Technology Assessment (CCOHTA); 2002. Technology Report No. 26. Available at: http://www.ccohta.ca/ccohta_production/entry_e.html. Accessed: September 6
Ungar WJ, Santos MT. 2003 The Pediatric Economic Database Evaluation (PEDE) project: Establishing a database to study trends in pediatric economic evaluation. Med Care. 41: 1142– 1152.Google Scholar
Ungar WJ, Santos MT. 2003 The Pediatric Quality Appraisal Questionnaire (PQAQ): An instrument for evaluation of the pediatric health economics literature. Value Health. 6: 584– 594.Google Scholar
Ungar WJ, Santos MT. 2004 Trends in pediatric economic evaluation: 1980 to 1999. Arch Dis Child. 89: 26– 29.Google Scholar
Warner KE, Hutton RC. 1980 Cost-benefit and cost-effectiveness analysis in health care. Growth and composition of the literature. Med Care. 18: 1069– 1084.Google Scholar
Zarnke K, Levine MAH, O'Brien BJ. 1997 Cost-benefit analyses in the health-care literature: Don't judge a study by its label. J Clin Epidemiol. 50: 813– 822.Google Scholar