Conducting systematic reviews of economic evaluations

TLDR

Systematic reviews of economic evaluations are debated for their limited ability to provide definitive cost‑effectiveness answers across diverse interventions. The study aims to present the outcomes of a 2012 working group that reviewed and updated the Joanna Briggs Institute guidance for conducting systematic reviews of economic evaluations. The working group conducted a literature review on the utility of such reviews, evaluated appraisal tools, and held a workshop, leading to revised JBI methodology that shifts the objective from a single cost‑effectiveness measure to summarizing estimates, considering study characteristics, and providing guidance on generalizability and synthesis.

Abstract

In 2012, a working group was established to review and enhance the Joanna Briggs Institute (JBI) guidance for conducting systematic review of evidence from economic evaluations addressing a question(s) about health intervention cost-effectiveness.The objective is to present the outcomes of the working group.The group conducted three activities to inform the new guidance: review of literature on the utility/futility of systematic reviews of economic evaluations and consideration of its implications for updating the existing methodology; assessment of the critical appraisal tool in the existing guidance against criteria that promotes validity in economic evaluation research and two other commonly used tools; and a workshop.The debate in the literature on the limitations/value of systematic review of economic evidence cautions that systematic reviews of economic evaluation evidence are unlikely to generate one size fits all answers to questions about the cost-effectiveness of interventions and their comparators. Informed by this finding, the working group adjusted the framing of the objectives definition in the existing JBI methodology. The shift is away from defining the objective as to determine one cost-effectiveness measure toward summarizing study estimates of cost-effectiveness and informed by consideration of the included study characteristics (patient, setting, intervention component, etc. ), identifying conditions conducive to lowering costs and maximizing health benefits. ), identifying conditions conducive to lowering costs and maximizing health benefits. ), providing more explicit guidance for assessing generalizability of findings; and offering a more robust method for evidence synthesis that facilitates achieving the more ambitious review objectives.