Understanding the relationship between costs and the modified Rankin Scale: A systematic review, multidisciplinary...

Area of Science:

• Health Economics
• Neurology
• Public Health

Background:

• Cost-of-illness studies often present a single aggregate disease cost.
• This is insufficient for conditions with varied outcomes like stroke.
• The modified Rankin Scale (mRS) is a standard stroke outcome measure.

Purpose of the Study:

• To systematically review evidence on stroke costs categorized by individual modified Rankin Scale (mRS) scores.
• To inform future cost-effectiveness modeling studies where disability outcomes are known but costs are not.

Main Methods:

• Systematic review of electronic databases (2004-2015).
• Searched for studies reporting costs by individual mRS categories.
• Included 13 studies meeting all criteria.

Main Results:

• Only four studies reported costs by mRS categories.
• Most studies included only direct medical costs; societal costs were rare.
• Costs consistently increased with higher mRS scores (greater disability).

Conclusions:

• Limited data exist on stroke costs stratified by mRS.
• Heterogeneity in costing methods hinders comparisons.
• Standardized methods are needed for future studies to improve cost-effectiveness analysis.