Institute for Research in Operative Medicine, Faculty of Health-School of Medicine, Witten/Herdecke University, Cologne, Germany.
Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Institute for Health Services and Health System Research, Neuruppin, Germany.
BMC Med Res Methodol. 2022 Feb 20;22(1):52. doi: 10.1186/s12874-022-01536-6.
For assessing cost-effectiveness, Health Technology Assessment (HTA) organisations may use primary economic evaluations (P-HEs) or Systematic Reviews of Health Economic evaluations (SR-HEs). A prerequisite for meaningful results of SR-HEs is that the results from existing P-HEs are transferable to the decision context (e.g, HTA jurisdiction). A particularly pertinent issue is the high variability of costs and resource needs across jurisdictions. Our objective was to review the methods documents of HTA organisations and compare their recommendations on considering transferability in SR-HE.
We systematically hand searched the webpages of 158 HTA organisations for relevant methods documents from 8th January to 31st March 2019. Two independent reviewers performed searches and selected documents according to pre-defined criteria. One reviewer extracted data in standardised and piloted tables and a second reviewer checked them for accuracy. We synthesised data using tabulations and in a narrative way.
We identified 155 potentially relevant documents from 63 HTA organisations. Of these, 7 were included in the synthesis. The included organisations have different aims when preparing a SR-HE (e.g. to determine the need for conducting their own P-HE). The recommendations vary regarding the underlying terminology (e.g. transferability/generalisability), the assessment approaches (e.g. structure), the assessment criteria and the integration in the review process.
Only few HTA organisations address the assessment of transferability in their methodological recommendations for SR-HEs. Transferability considerations are related to different purposes. The assessment concepts and criteria are heterogeneous. Developing standards to consider transferability in SR-HEs is desirable.
为了评估成本效益，卫生技术评估（HTA）机构可能会使用初级经济评估（P-HE）或健康经济评估的系统综述（SR-HE）。SR-HE 结果具有意义的前提是，现有 P-HE 的结果可转移到决策背景（例如，HTA 管辖范围）。一个特别相关的问题是，成本和资源需求在管辖范围内存在高度的可变性。我们的目的是审查 HTA 机构的方法文件，并比较他们对 SR-HE 中可转移性考虑的建议。
我们从 2019 年 1 月 8 日至 3 月 31 日，系统地在 158 个 HTA 机构的网页上手动搜索了相关的方法文件。两名独立的审查员根据预先确定的标准进行搜索和选择文件。一名审查员以标准化和试点表格提取数据，另一名审查员检查数据的准确性。我们使用列表和叙述方式综合数据。
我们从 63 个 HTA 机构中确定了 155 份可能相关的文件。其中，7 份被纳入综合分析。所包括的组织在准备 SR-HE 时具有不同的目的（例如，确定是否需要进行自己的 P-HE）。建议在基本术语（例如可转移性/可推广性）、评估方法（例如结构）、评估标准以及纳入审查过程等方面存在差异。
只有少数 HTA 机构在其关于 SR-HE 的方法建议中涉及可转移性的评估。可转移性考虑与不同的目的有关。评估概念和标准是多种多样的。制定考虑 SR-HE 中可转移性的标准是可取的。
