Economic evaluations of health care interventions in Oropharyngeal Dysphagia after Stroke: Protocol for a Systematic Review.

Abstract Background and purpose: Oropharyngeal Dysphagia (OD) affects 40-81% of patients after stroke. A recent systematic review on the costs of OD and it’s main complications showed higher acute and long-term costs for those patients who developed OD, malnutrition and pneumonia after stroke. These results suggest that appropriate management of post-stroke OD could lead to reduction of clinical complications and significant cost savings. The purpose of this systematic review is to assess the available literature exploring the efficiency or cost-effectiveness of available healthcare interventions on the appropriate management of OD. Methods: A systematic review on economic evaluations of health care interventions on post-stroke patients with OD following PRISMA recommendations will be performed. MEDLINE, Embase, the National Health Service Economic Evaluation Database and the Cost-Effectiveness Analysis Registry Database will be searched and a subsequent reference check will be done. English and Spanish literature will be included without date restrictions. Studies will be included if they refer to economic evaluations or studies in which cost savings were reported in post-stroke patients suffering OD. Studies will be excluded if they are partial economic evaluation studies, if they refer to esophageal dysphagia, or if OD is caused by causes different from stroke. Evidence will be presented and synthetized with a narrative method and using tables. Quality evaluation will be done using Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement. Discussion: The protocol for this systematic review is the first step to assess the cost-effectiveness of the healthcare interventions that have been described as potential treatments for post-stroke OD. This systematic review will summarize the current evidence on the relation between cost and benefits associated with the appropriate management of OD in post-stroke patients. Systematic review registration: PROSPERO CRD42020136245

Download Full-text

Economic evaluation of HIV testing options for low-prevalence high-income countries: a systematic review

Health Economics Review ◽

10.1186/s13561-021-00318-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Olanrewaju Medu ◽

Adegboyega Lawal ◽

Doug Coyle ◽

Kevin Pottie

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Hiv Testing ◽

High Income ◽

Economic Evaluations ◽

Rapid Hiv Testing ◽

The Cost ◽

Low Prevalence

Abstract Introduction This study reviewed the economic evidence of rapid HIV testing versus conventional HIV testing in low-prevalence high-income countries; evaluated the methodological quality of existing economic evaluations of HIV testing studies; and made recommendations on future economic evaluation directions of HIV testing approaches. Methods A systematic search of selected databases for relevant English language studies published between Jan 1, 2001, and Jan 30, 2019, was conducted. The methodological design quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) and the Drummond tool. We reported the systematic review according to the PRISMA guidelines. Results Five economic evaluations met the eligibility criteria but varied in comparators, evaluation type, perspective, and design. The methodologic quality of the included studies ranged from medium to high. We found evidence to support the cost-effectiveness of rapid HIV testing approaches in low-prevalence high-income countries. Rapid HIV testing was associated with cost per adjusted life year (QALY), ranging from $42,768 to $90,498. Additionally, regardless of HIV prevalence, rapid HIV testing approaches were the most cost-effective option. Conclusions There is evidence for the cost-effectiveness of rapid HIV testing, including the use of saliva-based testing compared to usual care or hospital-based serum testing. Further studies are needed to draw evidence on the relative cost-effectiveness of the distinct options and contexts of rapid HIV testing.

Download Full-text

A Systematic Review of Economic Evaluations of Health-Promoting Food Retail-Based Interventions

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031356 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1356

Author(s):

Huong Ngoc Quynh Tran ◽

Emma McMahon ◽

Marj Moodie ◽

Jaithri Ananthapavan

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Cost Utility ◽

Economic Evaluations ◽

Future Health ◽

Food Retail ◽

Sales Data ◽

Health Promoting ◽

The Cost

Background: While the number of retail interventions with impacts on diet- and/or health-related outcomes is increasing, the economic evaluation literature is limited. This review investigated (i) the cost-effectiveness of health-promoting food retail interventions and (ii) key assumptions adopted in these evaluations. Methods: A systematic review of published academic studies was undertaken (CRD42020153763). Fourteen databases were searched. Eligible studies were identified, analysed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: Eight studies that evaluated 30 retail interventions were included in the review. Common outcomes reported were cost per healthy food item purchased/served or cost per disability-adjusted life year (DALY) averted. Four studies undertook cost-utility analyses and half of these studies concluded that retail interventions were cost-effective in improving health outcomes. Most studies did not state any assumptions regarding compensatory behaviour (i.e., purchases/consumption of non-intervention foods or food purchases/consumption from non-intervention settings) and presumed that sales data were indicative of consumption. Conclusion: The cost-effectiveness of retail-based health-promoting interventions is inconclusive. Future health-promoting retail interventions should regularly include an economic evaluation which addresses key assumptions related to compensatory behaviour and the use of sales data as a proxy for consumption.

Download Full-text

Cost-effectiveness of oral anticancer drugs and associated individualised dosing approaches in patients with cancer: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-047173 ◽

2021 ◽

Vol 11 (8) ◽

pp. e047173

Author(s):

Madelé van Dyk ◽

Norma Bulamu ◽

Chelsea Boylan ◽

Anna M Mc Laughlin ◽

Ganessan Kichenadasse ◽

...

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Anticancer Drugs ◽

Health Economic Evaluation ◽

Health Benefit ◽

Bibliographic Databases ◽

Economic Evaluations ◽

The Cost ◽

Individualised Dosing

IntroductionOral anticancer drugs (OADs) have rapidly expanded with more than 70 OADs targeting several molecular targets. Many of the OADs exert an exposure–response relationship but still, a ‘one-size fits-all’ dose is used, ignoring interindividual variability. Several of these OADs share similar mechanisms of actions and thus target the same cancer and has resulted in a substantial research focus on comparing the health benefit of each. However, significantly less is known about the cost–benefit associated with OADs. This paper will provide a protocol to systematically review studies that have evaluated the cost-effectiveness of OADs and their associated individualised dosing interventions.Methods and analysisSystematic review methodology will be applied to identify, select and extract data from published economic evaluation (costs and outcomes/benefits) studies of OADs and their associated individualised dosing interventions. Bibliographic databases (eg, Ovid EMBASE, Ovid MEDLINE) will be used to perform the systematic literature search (between 1 January 2000 and October 2020). Only full economic evaluations will be included, but no restrictions on study outcomes will be applied. The quality of included primary studies will be assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist for reporting economic evaluations. Studies with low-quality evidence will be excluded. A narrative synthesis of the results from the included studies will be undertaken, with a subgroup analysis where appropriate.Ethics and disseminationThis systematic review will not require ethics approval as there will not be any collection of primary data. Findings of this review will be disseminated through publications in peer-reviewed journals, presentations at workshops or conferences and sharing through a media release. Findings from this review will provide evidence to direct and inform policy-makers where cost-neutral strategies may be effective or where dose individualising strategies may be economically beneficial. Additionally, gaps will be identified in the current literature to inform future-related research.PROSPERO registration numberCRD42020218170.Electronic supplemental materialThe online version of this article contains supplemental material, which is available to authorised users.

Download Full-text

The role of information provision in economic evaluations of non-invasive prenatal testing: a systematic review

The European Journal of Health Economics ◽

10.1007/s10198-019-01082-x ◽

2019 ◽

Vol 20 (8) ◽

pp. 1123-1131

Author(s):

Nikita M. John ◽

Stuart J. Wright ◽

Sean P. Gavan ◽

Caroline M. Vass

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Health Economic Evaluation ◽

Prenatal Testing ◽

Information Provision ◽

Economic Evaluations ◽

Non Invasive ◽

The Cost ◽

The Impact

Abstract Background Technological progress has led to changes in the antenatal screening programmes, most significantly the introduction of non-invasive prenatal testing (NIPT). The availability of a new type of testing changes the type of information that the parent(s) require before, during and after screening to mitigate anxiety about the testing process and results. Objectives To identify the extent to which economic evaluations of NIPT have accounted for the need to provide information alongside testing and the associated costs and health outcomes of information provision. Methods A systematic review of economic evaluations of NIPTs (up to February 2018) was conducted. Medline, Embase, CINAHL and PsychINFO were searched using an electronic search strategy combining a published economic search filter (from NHS economic evaluations database) with terms related to NIPT and screening-related technologies. Data were extracted using the Consolidated Health Economic Evaluation Reporting Standards framework and the results were summarised as part of a narrative synthesis. Results A total of 12 economic evaluations were identified. The majority of evaluations (n = 10; 83.3%) involved cost effectiveness analysis. Only four studies (33.3%) included the cost of providing information about NIPT in their economic evaluation. Two studies considered the impact of test results on parents’ quality of life by allowing utility decrements for different outcomes. Some studies suggested that the challenges of valuing information prohibited their inclusion in an economic evaluation. Conclusion Economic evaluations of NIPTs need to account for the costs and outcomes associated with information provision, otherwise estimates of cost effectiveness may prove inaccurate.

Download Full-text

Cost-effectiveness of treatment optimisation with biomarkers for immunotherapy in solid tumours: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-048141 ◽

2021 ◽

Vol 11 (9) ◽

pp. e048141

Author(s):

Sara Mucherino ◽

Valentina Lorenzoni ◽

Valentina Orlando ◽

Isotta Triulzi ◽

Marzia Del Re ◽

...

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Immune Checkpoint ◽

Cost Utility ◽

Solid Tumours ◽

Economic Evaluations ◽

Monetary Benefit ◽

The Cost ◽

Net Monetary Benefit

IntroductionThe combination of biomarkers and drugs is the subject of growing interest both from regulators, physicians and companies. This study protocol of a systematic review is aimed to describe available literature evidences about the cost-effectiveness, cost-utility or net-monetary benefit of the use of biomarkers in solid tumour as tools for customising immunotherapy to identify what further research needs.Methods and analysisA systematic review of the literature will be carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. PubMed and Embase will be queried from June 2010 to June 2021. The PICOS model will be applied: target population (P) will be patients with solid tumours treated with immune checkpoint inhibitors (ICIs); the interventions (I) will be test of the immune checkpoint predictive biomarkers; the comparator (C) will be any other targeted or non-targeted therapy; outcomes (O) evaluated will be health economic and clinical implications assessed in terms of incremental cost-effectiveness ratio, net health benefit, net monetary benefit, life years gained, quality of life, etc; study (S) considered will be economic evaluations reporting cost-effectiveness analysis, cost-utility analysis, net-monetary benefit. The quality of the evidence will be graded according to Grading of Recommendations Assessment, Development and Evaluation.Ethics and disseminationThis systematic review will assess the cost-effectiveness implications of using biomarkers in the immunotherapy with ICIs, which may help to understand whether this approach is widespread in real clinical practice. This research is exempt from ethics approval because the work is carried out on published documents. We will disseminate this protocol in a related peer-reviewed journal.PROSPERO registration numberCRD42020201549.

Download Full-text

Economic Evaluation of Home Care for Stroke Patients Compared to Hospital Care: A Systematic Review

Health Scope ◽

10.5812/ealthscope.112833 ◽

2021 ◽

Vol 10 (2) ◽

Author(s):

Maryam Khoramrooz ◽

Asra Asgharzadeh ◽

Saeide Alidoost ◽

Zeynab Foroughi ◽

Saber Azami ◽

...

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Home Care ◽

Hospital Care ◽

Cost Effective ◽

Stroke Patients ◽

Life Years ◽

Effective Option ◽

The Cost

Context: Stroke is one of the main causes of premature death and disability, imposing significant costs on the healthcare system, especially due to expensive hospital care. Home care service is one of the interventions used in the last two decades to reduce the cost of services provided for stroke patients in different countries. Objectives: The present study aimed to systematically review studies related to the economic evaluation of home care compared to hospital care for stroke patients. Data Sources: A search was conducted between January 1990 and January 2021. PubMed, Scopus, Web of Science, and Embase databases were searched systematically. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to select the studies. Data Extraction: To evaluate the quality of studies included in this systematic review, Drummond’s ten-item checklist was used. Results: Five economic evaluation studies were included in this review. The included studies reported different results regarding the effect of home care on improving different indicators and the cost-effectiveness ratio of home care to hospital care. Most previous studies reported that home care is a more cost-effective option for improving many indicators, such as physical function and quality-adjusted life years (QALY), and for reducing mortality and institutionalization, compared to hospital care. Conclusions: Home care is a more cost-effective option than hospital care for stroke patients with regard to some indicators, such as the Barthel index for Activities of Daily Living, Modified Rankin Scale (mRS), quality of life, mortality, and institutionalization. However, there are some exemptions to this conclusion. Due to limitations, such as heterogeneity of interventions in the existing studies, different levels of patients’ disabilities, different perspectives toward economic evaluation, and differences in the healthcare systems of countries, further research is needed according to the context of each country based on clinical trials.

Download Full-text

A Systematic Review of Methods, Study Quality, and Results of Economic Evaluation for Childhood and Adolescent Obesity Intervention

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16030485 ◽

2019 ◽

Vol 16 (3) ◽

pp. 485 ◽

Cited By ~ 3

Author(s):

Mandana Zanganeh ◽

Peymane Adab ◽

Bai Li ◽

Emma Frew

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Evidence Synthesis ◽

Evaluation Studies ◽

Cost Effective ◽

Adolescent Obesity ◽

Economic Evaluations ◽

Full Economic Evaluation ◽

Childhood And Adolescent Obesity

Many suggested policy interventions for childhood and adolescent obesity have costs and effects that fall outside the health care sector. These cross-sectorial costs and consequences have implications for how economic evaluation is applied and although previous systematic reviews have provided a summary of cost-effectiveness, very few have conducted a review of methods applied. We undertook this comprehensive review of economic evaluations, appraising the methods used, assessing the quality of the economic evaluations, and summarising cost-effectiveness. Nine electronic databases were searched for full-economic evaluation studies published between January 2001 and April 2017 with no language or country restrictions. 39 economic evaluation studies were reviewed and quality assessed. Almost all the studies were from Western countries and methods were found to vary by country, setting and type of intervention. The majority, particularly “behavioural and policy” preventive interventions, were cost-effective, even cost-saving. Only four interventions were not cost effective. This systematic review suggests that economic evaluation of obesity interventions is an expanding area of research. However, methodological heterogeneity makes evidence synthesis challenging. Whilst upstream interventions show promise, an expanded and consistent approach to evaluate cost-effectiveness is needed to capture health and non-health costs and consequences.

Download Full-text

The Cost-Effectiveness of Mobile Health (mHealth) Interventions for Older Adults: Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155290 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5290

Author(s):

Zartashia Ghani ◽

Johan Jarl ◽

Johan Sanmartin Berglund ◽

Martin Andersson ◽

Peter Anderberg

Keyword(s):

Older Adults ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Empirical Evidence ◽

Mobile Health ◽

Evaluation Studies ◽

Health Economic Evaluation ◽

Reporting Quality ◽

Economic Evaluations ◽

The Cost

The objective of this study was to critically assess and review empirical evidence on the cost-effectiveness of Mobile Health (mHealth) interventions for older adults. We systematically searched databases such as Pubmed, Scopus, and Cumulative Index of Nursing and Allied Literature (CINAHL) for peer-reviewed economic evaluations published in English from 2007 to 2018. We extracted data on methods and empirical evidence (costs, effects, incremental cost-effectiveness ratio) and assessed if this evidence supported the reported findings in terms of cost-effectiveness. The consolidated health economic evaluation reporting standards (CHEERS) checklist was used to assess the reporting quality of the included studies. Eleven studies were identified and categorized into two groups: complex smartphone communication and simple text-based communication. Substantial heterogeneity among the studies in terms of methodological approaches and types of intervention was observed. The cost-effectiveness of complex smartphone communication interventions cannot be judged due to lack of information. Limited evidence of cost-effectiveness was found for interventions related to simple text-based communications. Comprehensive economic evaluation studies are warranted to assess the cost-effectiveness of mHealth interventions designed for older adults.

Download Full-text

TECHNIQUES FOR DIAGNOSING OSTEOPOROSIS: A SYSTEMATIC REVIEW OF COST-EFFECTIVENESS STUDIES

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462314000257 ◽

2014 ◽

Vol 30 (3) ◽

pp. 273-281 ◽

Cited By ~ 2

Author(s):

Davide Minniti ◽

Ottavio Davini ◽

Maria Rosaria Gualano ◽

Maria Michela Gianino

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Postmenopausal Women ◽

Cost Effective ◽

Economic Evaluations ◽

Clear Cut ◽

Step Procedure ◽

Database Research ◽

The Cost ◽

Effectiveness Studies

Objectives:The study question was whether dual-energy X-ray absorptiometry (DXA) alone is more cost-effective for identifying postmenopausal women with osteoporosis than a two-step procedure with quantitative ultrasound sonography (QUS) plus DXA. To answer this question, a systematic review was performed.Methods:Electronic databases (PubMed, INAHTA, Health Evidence Network, NIHR, the Health Technology Assessment program, the NHS Economic Evaluation Database, Research Papers in Economics, Web of Science, Scopus, and EconLit) were searched for cost-effectiveness publications. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using the Drummond checklist.Results:Seven journal articles and four reports were reviewed. The cost per true positive case diagnosed by DXA was found to be higher than that for diagnosis by QUS+DXA in two articles. In one article it was found to be lower. In three studies, the results were not conclusive. These articles were characterized by the differences in the types of devices, parameters and thresholds on the QUS and DXA tests and the unit costs of the DXA and QUS tests as well as by variability in the sensitivity and specificity of the techniques and the prevalence of osteoporosis.Conclusions:The publications reviewed did not provide clear-cut evidence for drawing conclusions about which screening test may be more cost-effective for identifying postmenopausal women with osteoporosis.

Download Full-text

Economic evaluation and costs of telepsychiatry programmes: A systematic review

Journal of Telemedicine and Telecare ◽

10.1177/1357633x20938919 ◽

2020 ◽

pp. 1357633X2093891 ◽

Cited By ~ 1

Author(s):

John A Naslund ◽

Lauren M Mitchell ◽

Udita Joshi ◽

Dipal Nagda ◽

Chunling Lu

Keyword(s):

Mental Health ◽

Systematic Review ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Mental Disorders ◽

Clinical Care ◽

Mental Illnesses ◽

Economic Evaluations ◽

Schizophrenia Spectrum Disorders ◽

Post Traumatic Stress

Objective Telepsychiatry involves use of telecommunications technology to deliver psychiatric care and offers promise to reduce costs and increase access to mental health services. This systematic review examined cost reporting of telepsychiatry programmes for mental healthcare. Methods We systematically searched electronic databases for studies reporting costs, including economic evaluations such as cost-effectiveness analyses, or costs of developing telepsychiatry programmes for clinical care of mental disorders. Included studies enrolled participants with mental disorders and involved telepsychiatry for depression, anxiety disorders, serious mental illnesses including schizophrenia spectrum disorders and bipolar disorder, post-traumatic stress disorder, dementia or epilepsy. Results Twenty-six unique studies met inclusion criteria (17,967 participants), with most targeting depression ( n = 7; 27%), general mental disorders and screening ( n = 7; 27%), child mental health ( n = 4; 15%) and geriatric mental health ( n = 4; 15%). Nearly all studies ( n = 25; 96%) compared telepsychiatry programme costs with either standard in-person consultation or usual care, with 15 (60%) reporting that telepsychiatry programmes were less expensive, and 8 (32%) showing telepsychiatry programmes were more expensive. Three studies reported cost-effectiveness analyses, favouring telepsychiatry programmes, but at highly elevated cost-effectiveness thresholds. Few studies reported costs of developing or delivering telepsychiatry programmes. Conclusion Costs of telepsychiatry programmes varied widely, with substantial heterogeneity in how costs were defined and reported. Some programmes cost less than in-person services while others cost more. Therefore, rigorous cost-effectiveness studies following established standards in economic evaluation are needed to inform implementation and sustainability of these programmes in health systems.

Download Full-text