Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Division of Newborn Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Division of Neonatology, University of Florida, Gainesville, Florida, USA.
Semin Perinatol. 2021 Apr;45(3):151391. doi: 10.1016/j.semperi.2021.151391. Epub 2021 Jan 24.
Economic evaluations performed alongside randomized controlled trials benefit from the protections against bias inherent in randomization. In this systematic review, we assessed the frequency and quality of economic assessments alongside randomized controlled trials of interventions in neonates published between 1990 and 2016. Over that period, 58 economic assessments were published, corresponding to approximately 2% of RCTs. We noted significant methodological limitations of these studies, including limitation of included costs to the health sector or payer rather than broader categories such as family or community expenditures (81%), short time horizon for cost measurement (less than one year in 60%), lack of reporting of uncertainty (26%), and infrequent analysis of costs and effects in a single metric (combined in 45%). Strategies for improving the quality and frequency of economic evaluations in neonatology are discussed, including selection of appropriate trials, funding, and peer review.
经济评价与随机对照试验相结合具有随机化固有的抗偏倚保护。在这项系统评价中，我们评估了 1990 年至 2016 年间发表的新生儿干预措施的随机对照试验中经济评估的频率和质量。在此期间，发表了 58 项经济评估，约占 RCT 的 2%。我们注意到这些研究存在显著的方法学局限性，包括将纳入的成本局限于卫生部门或支付方，而不是家庭或社区支出等更广泛的类别（81%），成本测量的时间范围较短（60%的研究不到一年），缺乏不确定性报告（26%），以及很少在单一指标中分析成本和效果（45%的研究将二者结合分析）。讨论了提高新生儿学中经济评价的质量和频率的策略，包括选择适当的试验、资金和同行评审。
