Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?
Clinics
; 72(8): 499-509, Aug. 2017. tab, graf
Article
in English
| LILACS
| ID: biblio-890721
Responsible library:
BR1.1
ABSTRACT
The aim of this study is to identify and characterize the health economic evaluations (HEEs) of diagnostic tests conducted in Brazil, in terms of their adherence to international guidelines for reporting economic studies and specific questions in test accuracy reports. We systematically searched multiple databases, selecting partial and full HEEs of diagnostic tests, published between 1980 and 2013. Two independent reviewers screened articles for relevance and extracted the data. We performed a qualitative narrative synthesis. Forty-three articles were reviewed. The most frequently studied diagnostic tests were laboratory tests (37.2%) and imaging tests (32.6%). Most were non-invasive tests (51.2%) and were performed in the adult population (48.8%). The intended purposes of the technologies evaluated were mostly diagnostic (69.8%), but diagnosis and treatment and screening, diagnosis, and treatment accounted for 25.6% and 4.7%, respectively. Of the reviewed studies, 12.5% described the methods used to estimate the quantities of resources, 33.3% reported the discount rate applied, and 29.2% listed the type of sensitivity analysis performed. Among the 12 cost-effectiveness analyses, only two studies (17%) referred to the application of formal methods to check the quality of the accuracy studies that provided support for the economic model. The existing Brazilian literature on the HEEs of diagnostic tests exhibited reasonably good performance. However, the following points still require improvement 1) the methods used to estimate resource quantities and unit costs, 2) the discount rate, 3) descriptions of sensitivity analysis methods, 4) reporting of conflicts of interest, 5) evaluations of the quality of the accuracy studies considered in the cost-effectiveness models, and 6) the incorporation of accuracy measures into sensitivity analyses.
Full text:
Available
Collection:
International databases
Health context:
Sustainable Health Agenda for the Americas
Health problem:
Goal 4: Health financing
Database:
LILACS
Main subject:
Health Care Costs
/
Guideline Adherence
/
Diagnostic Tests, Routine
Type of study:
Diagnostic study
/
Practice guideline
/
Health economic evaluation
/
Prognostic study
/
Qualitative research
/
Systematic review
Limits:
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2017
Document type:
Article
/
Project document
Affiliation country:
Brazil
Institution/Affiliation country:
Campus Universitario Darcy Ribeiro/BR