Michael J Zoratti1, A Simon Pickard2, Peep F M Stalmeier3, Daniel Ollendorf4, Andrew Lloyd5, Kelvin K W Chan6,7, Don Husereau8, John E Brazier9, Murray Krahn10, Mitchell Levine1,11, Lehana Thabane1,12, Feng Xie13. 1. Department of Health Research Methodology, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. 2. Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, The University of Illinois at Chicago, Chicago, IL, USA. 3. Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands. 4. Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA. 5. Acaster Lloyd Consulting Ltd, London, UK. 6. Sunnybrook Odette Cancer Centre, Toronto, ON, Canada. 7. Canadian Centre for Applied Research in Cancer Control, Toronto, Canada. 8. School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. 9. School of Health and Related Research, University of Sheffield, Sheffield, UK. 10. Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada. 11. Department of Medicine, Division of Clinical Pharmacology and Toxicology, McMaster University, Hamilton, ON, Canada. 12. St Joseph's Healthcare, Hamilton, ON, Canada. 13. Department of Health Research Methodology, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. fengxie@mcmaster.ca.
Abstract
BACKGROUND: Published health utility studies are increasingly cited in cost-utility analyses to inform reimbursement decision-making. However, there is limited guidance for investigators looking to systematically evaluate the methodological quality of health utility studies or their applicability to decision contexts. OBJECTIVE: To describe how health utility concepts are reflected in tools intended for use with the health economic literature, particularly with respect to the evaluation of methodological quality and context applicability. METHODS: We reviewed the critical appraisal and reporting tools described in a 2012 report published by the Agency for Healthcare Research and Quality (AHRQ), supplemented with a keyword search of MEDLINE and EMBASE, to identify existing tools which include health utility constructs. From these tools, a list of relevant items was compiled and grouped into domain categories based on the methodological or applicability aspect they were directed toward. RESULTS: Of the 24 tools we identified, 12 contained items relevant to the evaluation of health utilities. Sixty-five items were considered relevant to the evaluation of quality, while 44 were relevant to the evaluation of applicability. Items were arranged into four domains: health state descriptions; selection and description of respondents; elicitation and measurement methods; and other considerations. CONCLUSION: As key inputs to cost-utility analyses, health utilities have the potential to significantly impact estimates of cost-effectiveness. Existing tools contain only general items related to the conduct or use of health utility studies. There is a need to develop tools that systematically evaluate the methodological quality and applicability of health utility studies.
BACKGROUND: Published health utility studies are increasingly cited in cost-utility analyses to inform reimbursement decision-making. However, there is limited guidance for investigators looking to systematically evaluate the methodological quality of health utility studies or their applicability to decision contexts. OBJECTIVE: To describe how health utility concepts are reflected in tools intended for use with the health economic literature, particularly with respect to the evaluation of methodological quality and context applicability. METHODS: We reviewed the critical appraisal and reporting tools described in a 2012 report published by the Agency for Healthcare Research and Quality (AHRQ), supplemented with a keyword search of MEDLINE and EMBASE, to identify existing tools which include health utility constructs. From these tools, a list of relevant items was compiled and grouped into domain categories based on the methodological or applicability aspect they were directed toward. RESULTS: Of the 24 tools we identified, 12 contained items relevant to the evaluation of health utilities. Sixty-five items were considered relevant to the evaluation of quality, while 44 were relevant to the evaluation of applicability. Items were arranged into four domains: health state descriptions; selection and description of respondents; elicitation and measurement methods; and other considerations. CONCLUSION: As key inputs to cost-utility analyses, health utilities have the potential to significantly impact estimates of cost-effectiveness. Existing tools contain only general items related to the conduct or use of health utility studies. There is a need to develop tools that systematically evaluate the methodological quality and applicability of health utility studies.
Keywords:
Checklist; Cost utility analysis; Health utility; Methodology
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