Sensitivity analysis in economic evaluation: a review of published studies

Area of Science:

• Health Economics
• Methodological Review

Background:

• Economic evaluation studies are crucial for healthcare decision-making.
• Handling uncertainty systematically is vital for reliable study conclusions.

Purpose of the Study:

• To assess the systematic and comprehensive handling of uncertainty in economic evaluation studies published in 1992.
• To identify deficiencies in addressing uncertainty within published economic evaluations.

Main Methods:

• A structured methodological review of 93 journal articles published in 1992.
• Analysis of how uncertainty was handled in data sources, generalizability, extrapolation, and analytic methods.
• Assessment of uncertainty representation in study results and overall performance rating.

Main Results:

• 22% of studies failed to consider uncertainty, and 38% used inadequate sensitivity analysis.
• Only 39% of studies adequately accounted for uncertainty, with 14% providing a good account.
• Significant shortcomings were found in the systematic and comprehensive handling of uncertainty.

Conclusions:

• Published economic evaluations in 1992 demonstrated considerable deficiencies in addressing uncertainty.
• The methods literature may lack sufficient detail on applying sensitivity analysis and presenting results.
• Journal editors and readers need to critically evaluate the handling of uncertainty in economic evaluations.