TY - JOUR
T1 - Cost-effectiveness and cost-benefit analyses in the medical literature
T2 - Are the methods being used correctly?
AU - Udvarhelyi, I. S.
AU - Colditz, G. A.
AU - Rai, A.
AU - Epstein, A. M.
PY - 1992/1/1
Y1 - 1992/1/1
N2 - Objective: To determine whether published cost-effectiveness and cost- benefit analyses have adhered to basic analytic principles. Design: Structured methodologic review of published articles. Study Sample: Seventy- seven articles published either from 1978 to 1980 or from 1985 to 1987 in general medical, general surgical, and medical subspecialty journals. Main Outcome Measurements: Articles were reviewed to assess the use and reporting of six fundamental principles of analysis. These principles were derived by reviewing widely cited textbooks and articles describing the methods for performing economic analyses and by selecting the methods universally recommended. Main Results: Overall performance was only fair. Three articles adhered to all six principles, and the median number of principles to which articles adhered was three. Among the problems noted were failure to make underlying assumptions explicit and, therefore, verifiable, and failure to test assumptions with sensitivity analyses. No improvement in performance was observed between 1978 and 1987. Articles in general medical journals, however, were more likely to use analytic methods appropriately than articles in the general surgical or medical subspecialty literature. Conclusions: Greater attention should be devoted to ensuring the appropriate use of analytic methods for economic analyses, and readers should make note of the methods used when interpreting the results of economic analyses.
AB - Objective: To determine whether published cost-effectiveness and cost- benefit analyses have adhered to basic analytic principles. Design: Structured methodologic review of published articles. Study Sample: Seventy- seven articles published either from 1978 to 1980 or from 1985 to 1987 in general medical, general surgical, and medical subspecialty journals. Main Outcome Measurements: Articles were reviewed to assess the use and reporting of six fundamental principles of analysis. These principles were derived by reviewing widely cited textbooks and articles describing the methods for performing economic analyses and by selecting the methods universally recommended. Main Results: Overall performance was only fair. Three articles adhered to all six principles, and the median number of principles to which articles adhered was three. Among the problems noted were failure to make underlying assumptions explicit and, therefore, verifiable, and failure to test assumptions with sensitivity analyses. No improvement in performance was observed between 1978 and 1987. Articles in general medical journals, however, were more likely to use analytic methods appropriately than articles in the general surgical or medical subspecialty literature. Conclusions: Greater attention should be devoted to ensuring the appropriate use of analytic methods for economic analyses, and readers should make note of the methods used when interpreting the results of economic analyses.
KW - Cost benefit analysis
KW - Cost control
KW - Economics, medical
KW - Outcome and process assessment (health care)
KW - Sensitivity and specificity
UR - http://www.scopus.com/inward/record.url?scp=0026526874&partnerID=8YFLogxK
U2 - 10.7326/0003-4819-116-3-238
DO - 10.7326/0003-4819-116-3-238
M3 - Review article
C2 - 1530808
AN - SCOPUS:0026526874
VL - 116
SP - 238
EP - 244
JO - Annals of Internal Medicine
JF - Annals of Internal Medicine
SN - 0003-4819
IS - 3
ER -