Hutter Maria-Florencia, Rodríguez-Ibeas Roberto, Antonanzas Fernando
Department of Economics, University of La Rioja, 26004, Logroño, Spain.
Eur J Health Econ. 2014 Nov;15(8):829-40. doi: 10.1007/s10198-013-0527-7. Epub 2013 Aug 24.
An increasing number of published studies of economic evaluations of health technologies have been reviewed and summarized with different purposes, among them to facilitate decision-making processes. These reviews have covered different aspects of economic evaluations, using a variety of methodological approaches. The aim of this study is to analyze the methodological characteristics of the reviews of economic evaluations in health care, published during the period 1990-2010, to identify their main features and the potential missing elements. This may help to develop a common procedure for elaborating these kinds of reviews.
We performed systematic searches in electronic databases (Scopus, Medline and PubMed) of methodological reviews published in English, period 1990-2010. We selected the articles whose main purpose was to review and assess the methodology applied in the economic evaluation studies. We classified the data according to the study objectives, period of the review, number of reviewed studies, methodological and non-methodological items assessed, medical specialty, type of disease and technology, databases used for the review and their main conclusions. We performed a descriptive statistical analysis and checked how generalizability issues were considered in the reviews.
We identified 76 methodological reviews, 42 published in the period 1990-2001 and 34 during 2002-2010. The items assessed most frequently (by 70% of the reviews) were perspective, type of economic study, uncertainty and discounting. The reviews also described the type of intervention and disease, funding sources, country in which the evaluation took place, type of journal and author's characteristics. Regarding the intertemporal comparison, higher frequencies were found in the second period for two key methodological items: the source of effectiveness data and the models used in the studies. However, the generalizability issues that apparently are creating a growing interest in the economic evaluation literature did not receive as much attention in the reviews of the second period. The remaining items showed similar frequencies in both periods.
Increasingly more reviews of economic evaluation studies aim to analyze the application of methodological principles, and offer summaries of papers classified by either diseases or health technologies. These reviews are useful for finding literature trends, aims of studies and possible deficiencies in the implementation of methods of specific health interventions. As no significant methodological improvement was clearly detected in the two periods analyzed, it would be convenient to pay more attention to the methodological aspects of the reviews.
越来越多已发表的关于卫生技术经济评估的研究被出于不同目的进行回顾和总结，其中包括为了促进决策过程。这些回顾涵盖了经济评估的不同方面，采用了多种方法。本研究的目的是分析1990年至2010年期间发表的医疗保健经济评估回顾的方法学特征，以确定其主要特点和潜在的缺失要素。这可能有助于制定一种阐述这类回顾的通用程序。
我们在电子数据库（Scopus、Medline和PubMed）中对1990年至2010年期间以英文发表的方法学回顾进行了系统检索。我们选择了主要目的是回顾和评估经济评估研究中所应用方法的文章。我们根据研究目标、回顾时期、被回顾研究的数量、评估的方法学和非方法学项目、医学专科、疾病和技术类型、用于回顾的数据库及其主要结论对数据进行分类。我们进行了描述性统计分析，并检查了回顾中如何考虑可推广性问题。
我们确定了76篇方法学回顾，其中42篇发表于1990年至2001年期间，34篇发表于2002年至2010年期间。评估频率最高的项目（70%的回顾涉及）是视角、经济研究类型、不确定性和贴现。这些回顾还描述了干预和疾病类型、资金来源、评估所在国家、期刊类型和作者特征。关于跨时期比较，在第二个时期，两个关键方法学项目的频率更高：有效性数据来源和研究中使用的模型。然而，在第二个时期的回顾中，那些显然在经济评估文献中引起越来越多关注的可推广性问题并未得到同样多的关注。其余项目在两个时期的频率相似。
越来越多的经济评估研究回顾旨在分析方法学原则的应用，并提供按疾病或卫生技术分类的论文总结。这些回顾有助于发现文献趋势、研究目的以及特定卫生干预措施方法实施中可能存在的不足。由于在所分析的两个时期中未明显检测到显著的方法学改进，因此更关注回顾的方法学方面将是有益的。
