Health Economics Information Resources: A Self-Study Course
Module 4: An Introduction to the Principles of Critical Appraisal of Health Economic Evaluation Studies
Drummond's check-list for assessing economic evaluations
(Drummond M et al. Methods for the economic evaluation of health care programmes. 2nd ed. Oxford. Oxford University Press. 1997)1. Was a well-defined question posed in answerable form?
1.1. Did the study examine both costs and effects of the service(s) or programme(s)?2. Was a comprehensive description of the competing alternatives given (i.e. can you tell who did what to whom, where, and how often)?
2.1. Were there any important alternatives omitted?3. Was the effectiveness of the programme or services established?
3.1. Was this done through a randomised, controlled clinical trial? If so, did the trial protocol reflect what would happen in regular practice?4. Were all the important and relevant costs and consequences for each alternative identified?
4.1. Was the range wide enough for the research question at hand?5. Were costs and consequences measured accurately in appropriate physical units (e.g. hours of nursing time, number of physician visits, lost work-days, gained life years)?
5.1. Were any of the identified items omitted from measurement? If so, does this mean that they carried no weight in the subsequent analysis?6. Were the cost and consequences valued credibly?
6.1. Were the sources of all values clearly identified? (Possible sources include market values, patient or client preferences and views, policy-makers’ views and health professionals’ judgements)7. Were costs and consequences adjusted for differential timing?
7.1. Were costs and consequences that occur in the future ‘discounted’ to their present values?8. Was an incremental analysis of costs and consequences of alternatives performed?
8.1. Were the additional (incremental) costs generated by one alternative over another compared to the additional effects, benefits, or utilities generated?9. Was allowance made for uncertainty in the estimates of costs and consequences?
9.1. If data on costs and consequences were stochastic (randomly determined sequence of observations), were appropriate statistical analyses performed?10. Did the presentation and discussion of study results include all issues of concern to users?
10.1. Were the conclusions of the analysis based on some overall index or ratio of costs to consequences (e.g. cost-effectiveness ratio)? If so, was the index interpreted intelligently or in a mechanistic fashion?