Challenges in Systematic Reviews of Economic Analyses

21 June 2005 | Volume 142 Issue 12 Part 2 | Pages 1073-1079

Economic analyses can provide valuable information for health care decision makers. Systematic reviews of economic analyses can integrate information from multiple studies and provide important insights by systematically examining how differences between models lead to different results. We use our experience in developing and implementing systematic reviews of economic analyses for the U.S. Preventive Services T ask Force, particularly our systematic review of the cost–effectiveness of colorectal cancer screening, to illustrate key methodologic challenges and suggest a framework for other researchers in this area.

Author and Article Information

From University of North Carolina, Chapel Hill, North Carolina; Portland Veterans Affairs Medical Center and Oregon Health & Science University, Portland, Oregon; RTI International and the RTI–University of North Carolina Evidence-based Practice Center, Research Triangle Park, North Carolina; Merck & Co., Inc., West Point, Pennsylvania; and Georgetown University Medical Center and Lombardi Comprehensive Cancer Center, Washington, DC.

Disclaimer: The authors are responsible for the contents of this article, including any clinical or treatment recommendations. No statement in this article should be construed as an official position from the U.S. Agency for Healthcare Research and Quality, the U.S. Department of Health and Human Services, or Merck & Co., Inc.

Acknowledgments: The authors thank Loraine Monroe of RTI International for dedicated document preparation efforts.

Grant Support: By contract 290-02-0016 from the Agency for Healthcare Research and Quality to RTI International (Drs. Pignone, Hoerger, and Lohr); by contract 290-97-0018 from the Agency for Healthcare Research and Quality to Oregon Health Sciences University (Dr. Saha); and by grant numbers U01CA88283A and K05CA96940 from the National Cancer Institute (Dr. Mandelblatt). Dr. Saha was also supported by a Research Career Development award from the Health Services Research & Development Service of the Department of Veterans Affairs and a Generalist Physician Faculty Scholar award from the Robert Wood Johnson Foundation.

Potential Financial Conflicts of Interest: Authors of this paper have received funding for Evidence-based Practice Center reports.

Requests for Single Reprints: Michael P. Pignone, MD, MPH, Division of General Internal Medicine, Department of Medicine, University of North Carolina, Chapel Hill, 5039 Old Clinic Building, UNC Hospital, Chapel Hill, NC 27599-7110; e-mail, Pignone{at}med.unc.edu.

Current Author Addresses: Dr. Pignone: Cecil Sheps Center for Health Services Research, Department of Medicine, University of North Carolina, 5039 Old Clinic Building UNC Hospital, Chapel Hill, NC 27599-7110.

Dr. Saha: Portland Veterans Affairs Medical Center (P3MED), 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239.

Drs. Hoerger and Lohr: RTI International and the RTI—University of North Carolina Evidence-based Practice Center, RTI International, 3040 Cornwallis Road, Research Triangle Park, North Carolina 27709.

Dr. Teutsch: Outcomes Research and Management, PO Box 4, WP39-130, Merck & Co., Inc., West Point, PA 19486-0004.

Dr. Mandelblatt: Georgetown University Medical Center and Cancer Control Program, Lombardi Comprehensive Cancer Center, Cancer Control Program, 2233 Wisconsin Avenue, Suite 317, Washington, DC 20007.