Measuring cost-effectiveness of surgical procedures

Area of Science:

• Health Economics
• Surgical Outcomes Research
• Cost-Effectiveness Analysis

Background:

• Many existing cost-effectiveness analyses (CEA) of surgical procedures do not follow recommended analytic guidelines.
• Authors who specifically plan CEA studies are more likely to adhere to methodologic principles.
• Methodologic reviews for CEA are available and strongly encouraged for investigators.

Purpose of the Study:

• To review the adherence to analytic guidelines in existing CEA literature for surgical procedures.
• To highlight examples of CEA, cost-utility analysis (CUA), and threshold analysis in gynecologic surgery.
• To emphasize the importance of appropriate time frames and effectiveness measures in economic evaluations.

Main Methods:

• Review of existing literature on CEA of surgical procedures, with a focus on gynecologic surgery.
• Analysis of specific examples including threshold analysis, CUA, and long-term economic evaluations.
• Discussion of methodologic challenges such as selecting appropriate time frames and effectiveness measures.

Main Results:

• A significant portion of CEA literature lacks adherence to basic analytic guidelines.
• Studies with planned CEA analyses generally meet most methodologic principles.
• Examples demonstrate varied results based on analysis type, time frame, and effectiveness measures (e.g., QALYs, cure rates, life expectancy).

Conclusions:

• Investigators conducting CEA are encouraged to utilize existing methodologic reviews.
• Careful consideration of analysis time frames and effectiveness measures is critical for accurate economic evaluations.
• Adherence to CEA guidelines enhances the reliability and informativeness of surgical economic studies.