EBM - Evaluating a Economic Analysis Study

MUSM Libraries: Evaluating an ECONOMIC ANALYSIS article

Appraise | Types of cost analysis | Finding articles

Appraise

What did they do? (Methods)
1. Did the analysis provide a full economic comparison of health care strategies?
2. Were the costs and outcomes properly measured and valued?
3. Was appropriate allowance made for uncertainties in the analysis?
4. Are estimates of costs and outcomes related to the baseline risk in the treatment population?
What was the answer? (Results)
1. What were the incremental costs and outcomes of each strategy?
2. Do incremental costs and outcomes differ between subgroups?
3. How much does allowance for uncertainty change the results?
What did they say about the answer? (Conclusion)
1. Do the results of the study support the author/s conclusions?
2. Does the conclusion reflect the discussion?
3. Are there study limitations, and do these impact the conclusions?
4. Are potential discrepancies mentioned?
What do I do with this information?
1. Are the treatment benefits worth the harms and costs?
2. Could my patients expect similar health outcomes?
3. Could I expect similar costs?

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Types of cost analysis

Economics is not just about money. It explores the balance between costs and consequences of alternative actions.

A full economic comparison analyzes both the costs and consequences of 2 or more alternative healthcare strategies. There are 3 types:

Cost-Benefit Analysis compares the strategies' costs with benefits expressed in monetary units.

Cost-Effectiveness Analysis compares the strategies' costs with their effects in clinical units (e.g. cost per life years gained).

Cost-Utility Analysis is a type of cost-effectiveness analysis in which outcomes are measured in terms of social value (e.g. cost per quality-adjusted life years or QALY).

Direct Health Costs measure actual resources consumed to provide healthcare.

Indirect Health Costs measure resource implications of healthcare on other activities (e.g. lost wages).

Discounting permits a comparison of future costs and consequences at today's value.

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Finding articles about economic analysis

PubMed:

Select PubMed@Mercer and enter your search term/s AND (cost* OR economic)
SelectPubMed@Mercer then Topic Specific Queries, then Health Services Research (HSR) Queries. Enter your searth term/s and select Costs or Economics

References:

JAMA 1997 277:1552-1557

From: Guyatt, G. Users' Guides to the Medical Literature: Essentials of Evidence-based Clinical Practice. AMA Press, 2002 and Strauss. Evidence-Based Medicine. How to Practice and Teach EBM. Churchill-Livingstone, 3rd edition, 2005 (pocket cards).

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