A systematic review of pharmacoeconomic guidelines

<p><b>Objective:</b> To review, summarize, and analyze both similarities and differences of pharmacoeconomic (PE) guidelines, to enable researchers to access their characteristics and the current state of PE guidelines; furthermore, to learn which methodological issues still remain contested and to promote the methodological development of PE guidelines.</p> <p><b>Materials and methods:</b> The authors performed a search for PE guidelines using PubMed, the Cochrane library database, and the websites of the International Society for Pharmacoeconomics and Outcomes Research. Information of each guideline was extracted using a pre-designed extraction template, which included 22 aspects; the guidelines were summarized in the forms of charts, and their characteristics have been described.</p> <p><b>Results:</b> A total of 40 PE guidelines were studied. The most common methodological issues include the types of analysis, sources for effectiveness, use of quality-adjusted life-years (QALYs) to measure outcomes, and use of incremental cost effectiveness ratios to present results. The majority of the guidelines preferred a cost utility analysis with outcomes expressed in terms of QALYs. Most of the guidelines preferred meta-analysis or meta-analysis of the randomized controlled trials, and required a systematic review of all evidence. Issues that varied most in the guidelines were the choice of the comparator, recommended costs to be included, methods related to indirect cost calculations, methods of sensitivity analysis, and discounting rate.</p> <p><b>Conclusion:</b> A comparison of these guidelines revealed that a number of differences exist among them in several key aspects, and some critical methodological issues still exist, for which no best solution is available. Furthermore, efforts need to be made to develop harmonious methods for the PE, and to improve the transferability of the outcomes of PE evaluations.</p

The Assessment of the Quality of Reporting of Systematic Reviews/Meta-Analyses in Diagnostic Tests Published by Authors in China

<div><p>Background</p><p>The quality of reporting in systematic reviews (SRs)/meta-analyses (MAs) of diagnostic tests published by authors in China has not been evaluated. The aims of present study are to evaluate the quality of reporting in diagnostic SRs/MAs using the PRISMA statement and determine the changes in the quality of reporting over time.</p><p>Methods</p><p>According to the inclusion and exclusion criteria, we searched five databases including Chinese Biomedical Literature Database, PubMed, EMBASE, the Cochrane Library, and Web of knowledge, to identify SRs/MAs on diagnostic tests. The searches were conducted on July 14, 2012 and the cut off for inclusion of the SRs/MAs was December 31^st 2011. The PRISMA statement was used to assess the quality of reporting. Analysis was performed using Excel 2003, RevMan 5.</p><p>Results</p><p>A total of 312 studies were included. Fifteen diseases systems were covered. According to the PRISMA checklist, there had been serious reporting flaws in following items: structured summary (item 2, 22.4%), objectives (item 4, 18.9%), protocol and registration (item 5, 2.6%), risk of bias across studies (item 15, 26.3%), funding (item 27, 28.8%). The subgroup analysis showed that there had been some statistically significant improvement in total compliance for 9 PRISMA items after the PRISMA was released, 6 items were statistically improved regarding funded articles, 3 items were statistically improved for CSCD articles, and there was a statistically significant increase in the proportion of reviews reporting on 22 items for SCI articles (P<0.050).</p><p>Conclusion</p><p>The numbers of diagnostic SRs/MAs is increasing annually. The quality of reporting has measurably been improved over the previous years. Unfortunately, there are still many deficiencies in the reporting including protocol and registration, search, risk of bias across studies, and funding. Future Chinese reviewers should address issues on these aspects.</p></div

Number of included systematic reviews/Meta-analyses per year of publication.

<p>Number of included systematic reviews/Meta-analyses per year of publication.</p

Data extraction items of included studies.

<p>(Notes: RCT: Randomized Controlled Trials; SR: Systematic review; MA: Meta-analysis).</p

Changing pattern of quality assessment in diagnostic systematic reviews/Meta-analyses.

<p>Changing pattern of quality assessment in diagnostic systematic reviews/Meta-analyses.</p

Comparison of the quality of reporting of included systematic reviews/Meta-analyses based on the publication time.

<p>Comparison of the quality of reporting of included systematic reviews/Meta-analyses based on the publication time.</p

The results of quality assessment of reporting (n = 312).

<p>The results of quality assessment of reporting (n = 312).</p

Flow chart of article screening and selection process.

<p>Flow chart of article screening and selection process.</p

Comparison of the quality of reporting of included systematic reviews/Meta-analyses from CSCD vs non CSCD.

<p>Comparison of the quality of reporting of included systematic reviews/Meta-analyses from CSCD vs non CSCD.</p

Characteristics of included systematic reviews/meta-analyses.

<p>(Notes: RCT: Randomized Controlled Trials; CSCD: Chinese Science Citation Database; SCI: Science Citation Index).</p