In search of the evidentiary foundation of published Canadian economic evaluations (2001-06).
OBJECTIVE
The aim of this study was to present a review of economic evaluations conducted from a Canadian perspective and to characterize sources of evidence and statistical methods to analyze effectiveness measures, resource utilization, and uncertainty.


METHODS
A search strategy was developed to identify Canadian economic evaluations published between January 2001 and June 2006. A standardized abstraction form was used to extract key data (e.g., study design, data sources, statistical methods).


RESULTS
A total of 153 unique studies were included for review, of which 75 were evaluations of drug therapies and less than half were funded by industry. Cost-effectiveness analysis was the most common type of economic evaluation and 80 percent of the studies used modeling techniques. A single source of evidence for effectiveness measures was used in half of the studies. Statistical methods were commonly reported to compare effectiveness measures when the economic evaluation was conducted alongside a clinical trial but less commonly when determining effectiveness input parameters in model-based economic evaluations, or to analyze resource utilization data. Authors relied mostly on univariate sensitivity analyses to explore uncertainty.


CONCLUSIONS
This review identifies the need to improve the conduct and reporting of statistical methods for economic evaluations to improve confidence in the results.
Tarride
Jean-Eric
JE
Department of Clinical Epidemiology & Biostatistics, McMaster University, Programs for Assessment of Technology in Health (PATH) Research Institute, 25 Main Street West, Suite 2000, Hamilton, Ontario L8P 1H1, Canada. tarride@mcmaster.ca
Lim
Morgan E
ME
Bowen
James M
JM
McCarron
Catherine Elizabeth
CE
Blackhouse
Gord
G
Hopkins
Robert
R
O'Reilly
Daria
D
Xie
Feng
F
Goeree
Ron
R