Matteo Ruggeri1, Andrea Manca2, Silvia Coretti3, Paola Codella1, Valentina Iacopino1, Federica Romano1, Daniele Mascia1, Valentina Orlando4, Americo Cicchetti1. 1. Director of Post-Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy. 2. Centre for Health Economics, University of York, York, UK. 3. Director of Post-Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: silvia.coretti@rm.unicatt.it. 4. Inter-departmental Research Centre of PharmacoEconomics and Drug utilization (CIRFF), Center of Pharmacoeconomics, Federico II University of Naples, Naples, Italy.
Abstract
OBJECTIVES: To assess the methodological quality of Italian health economic evaluations and their generalizability or transferability to different settings. METHODS: A literature search was performed on the PubMed search engine to identify trial-based, nonexperimental prospective studies or model-based full economic evaluations carried out in Italy from 1995 to 2013. The studies were randomly assigned to four reviewers who applied a detailed checklist to assess the generalizability and quality of reporting. The review process followed a three-step blinded procedure. The reviewers who carried out the data extraction were blind as to the name of the author(s) of each study. Second, after the first review, articles were reassigned through a second blind randomization to a second reviewer. Finally, any disagreement between the first two reviewers was solved by a senior researcher. RESULTS: One hundred fifty-one economic evaluations eventually met the inclusion criteria. Over time, we observed an increasing transparency in methods and a greater generalizability of results, along with a wider and more representative sample in trials and a larger adoption of transition-Markov models. However, often context-specific economic evaluations are carried out and not enough effort is made to ensure the transferability of their results to other contexts. In recent studies, cost-effectiveness analyses and the use of incremental cost-effectiveness ratio were preferred. CONCLUSIONS: Despite a quite positive temporal trend, generalizability of results still appears as an unsolved question, even if some indication of improvement within Italian studies has been observed.
OBJECTIVES: To assess the methodological quality of Italian health economic evaluations and their generalizability or transferability to different settings. METHODS: A literature search was performed on the PubMed search engine to identify trial-based, nonexperimental prospective studies or model-based full economic evaluations carried out in Italy from 1995 to 2013. The studies were randomly assigned to four reviewers who applied a detailed checklist to assess the generalizability and quality of reporting. The review process followed a three-step blinded procedure. The reviewers who carried out the data extraction were blind as to the name of the author(s) of each study. Second, after the first review, articles were reassigned through a second blind randomization to a second reviewer. Finally, any disagreement between the first two reviewers was solved by a senior researcher. RESULTS: One hundred fifty-one economic evaluations eventually met the inclusion criteria. Over time, we observed an increasing transparency in methods and a greater generalizability of results, along with a wider and more representative sample in trials and a larger adoption of transition-Markov models. However, often context-specific economic evaluations are carried out and not enough effort is made to ensure the transferability of their results to other contexts. In recent studies, cost-effectiveness analyses and the use of incremental cost-effectiveness ratio were preferred. CONCLUSIONS: Despite a quite positive temporal trend, generalizability of results still appears as an unsolved question, even if some indication of improvement within Italian studies has been observed.
Authors: Roberto Latina; Katia Salomone; Daniela D'Angelo; Daniela Coclite; Greta Castellini; Silvia Gianola; Alice Fauci; Antonello Napoletano; Laura Iacorossi; Primiano Iannone Journal: Int J Environ Res Public Health Date: 2020-11-20 Impact factor: 3.390