Mathes Tim, Walgenbach Maren, Antoine Sunya-Lee, Pieper Dawid, Eikermann Michaela
Institute for Research in Operative Medicine, Witten/Herdecke University, Cologne, Germany (TM, MW, SLA, DP, ME).
Med Decis Making. 2014 Oct;34(7):826-40. doi: 10.1177/0272989X14526470. Epub 2014 Apr 8.
The quality of systematic reviews of health economic evaluations (SR-HE) is often limited because of methodological shortcomings. One reason for this poor quality is that there are no established standards for the preparation of SR-HE. The objective of this study is to compare existing methods and suggest best practices for the preparation of SR-HE.
To identify the relevant methodological literature on SR-HE, a systematic literature search was performed in Embase, Medline, the National Health System Economic Evaluation Database, the Health Technology Assessment Database, and the Cochrane methodology register, and webpages of international health technology assessment agencies were searched. The study selection was performed independently by 2 reviewers. Data were extracted by one reviewer and verified by a second reviewer. On the basis of the overlaps in the recommendations for the methods of SR-HE in the included papers, suggestions for best practices for the preparation of SR-HE were developed.
Nineteen relevant publications were identified. The recommendations within them often differed. However, for most process steps there was some overlap between recommendations for the methods of preparation. The overlaps were taken as basis on which to develop suggestions for the following process steps of preparation: defining the research question, developing eligibility criteria, conducting a literature search, selecting studies, assessing the methodological study quality, assessing transferability, and synthesizing data.
The differences in the proposed recommendations are not always explainable by the focus on certain evaluation types, target audiences, or integration in the decision process. Currently, there seem to be no standard methods for the preparation of SR-HE. The suggestions presented here can contribute to the harmonization of methods for the preparation of SR-HE.
由于方法学上的缺陷，卫生经济评估系统评价（SR-HE）的质量常常受到限制。质量欠佳的一个原因是，目前尚无编制SR-HE的既定标准。本研究的目的是比较现有方法，并提出编制SR-HE的最佳实践建议。
为了识别有关SR-HE的相关方法学文献，我们在Embase、Medline、国家卫生系统经济评估数据库、卫生技术评估数据库和Cochrane方法学注册库中进行了系统的文献检索，并搜索了国际卫生技术评估机构的网页。由两名评审员独立进行研究筛选。数据由一名评审员提取，并由另一名评审员核实。基于纳入论文中关于SR-HE方法的建议重叠部分，制定了编制SR-HE最佳实践的建议。
共识别出19篇相关出版物。其中的建议常常存在差异。然而，对于大多数流程步骤，编制方法的建议之间存在一些重叠。这些重叠部分被用作基础，据此为以下编制流程步骤提出建议：确定研究问题、制定纳入标准、进行文献检索、选择研究、评估方法学研究质量、评估可转移性以及综合数据。
所提出建议的差异并不总是能够通过对特定评估类型、目标受众或决策过程中的整合等方面的关注来解释。目前，似乎不存在编制SR-HE的标准方法。此处提出的建议有助于统一SR-HE的编制方法。
