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Cost-effectiveness analyses in gynecologic oncology: methodological quality and trends
Michael R Manuel1, Lee-May Chen, Aaron B Caughey
1Department of Obstetrics, Gynecology and Reproductive Sciences, University of California at San Francisco (UCSF), San Francisco, CA 94143, USA.
Gynecologic Oncology
|March 30, 2004
Summary
Cost-effectiveness analyses in gynecologic oncology have improved in quality over time. Further enhancements in methodology are needed for incremental and sensitivity analyses to accurately interpret results.
Area of Science:
- Health Economics
- Gynecologic Oncology
Background:
- Cost-effectiveness analyses (CEA) are increasingly used in healthcare decision-making.
- Evaluating the methodological quality of CEAs in gynecologic oncology is crucial for reliable interpretation.
Purpose of the Study:
- To assess the methodological quality and identify trends in CEA studies published in gynecologic oncology.
- To determine the evolution of CEA methodology in the field over time.
Main Methods:
- A comprehensive literature search identified 68 relevant articles published between 1966 and 2002.
- Ten key methodological principles were used to score each CEA, with a maximum possible score of 20.
- Statistical analyses included Student t test, ANOVA, and linear regression to evaluate trends and quality.
Main Results:
- The mean methodological score was 16.1 (+/-4.1), with a significant improvement observed over time (P = 0.01).
- Primary CEAs and studies involving public health or healthcare economics investigators demonstrated higher quality.
- Common limitations included issues with incremental analyses, sensitivity analyses, and discounting.
Conclusions:
- Methodological quality of CEAs in gynecologic oncology has significantly improved over the past two decades.
- Areas requiring further improvement include incremental comparisons and sensitivity analysis methodology.
- A thorough understanding of CEA methodology is essential for accurate interpretation of findings by all stakeholders.
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