title: A systematic review of the quality of economic models comparing thrombosis inhibitors in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
abstract: BACKGROUND
  Thrombosis inhibitors can be used to treat acute coronary syndromes (ACS). However, there are various alternative treatment strategies, of which some have been compared using health economic decision models.
  
  
  OBJECTIVE
  To assess the quality of health economic decision models comparing thrombosis inhibitors in patients with ACS undergoing percutaneous coronary intervention, and to identify areas for quality improvement.
  
  
  METHODS
  The literature databases MEDLINE, EMBASE, EconLit, National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment (HTA).
  
  
  METHODS
  A review of the quality of health economic decision models was conducted by two independent reviewers, using the Philips checklist.
  
  
  RESULTS
  Twenty-one relevant studies were identified. Differences were apparent regarding the model type (six decision trees, four Markov models, eight combinations, three undefined models), the model structure (types of events, Markov states) and the incorporation of data (efficacy, cost and utility data). Critical issues were the absence of particular events (e.g. thrombocytopenia, stroke) and questionable usage of utility values within some studies.
  
  
  CONCLUSIONS
  As we restricted our search to health economic decision models comparing thrombosis inhibitors, interesting aspects related to the quality of studies of adjacent medical areas that compared stents or procedures could have been missed.
  
  
  CONCLUSIONS
  This review identified areas where recommendations are indicated regarding the quality of future ACS decision models. For example, all critical events and relevant treatment options should be included. Models also need to allow for changing event probabilities to correctly reflect ACS and to incorporate appropriate, age-specific utility values and decrements when conducting cost-utility analyses.
authors: Hamburg Center for Health Economics, University of Hamburg, 20354, Hamburg, Germany, Maximilian.Hatz@wiso.uni-hamburg.de.
authors: Maximilian H M
authors: MH
authors: Hatz
authors: Reiner
authors: R
authors: Leidl
authors: Nichola A
authors: NA
authors: Yates
authors: Björn
authors: B
authors: Stollenwerk
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000191:economics / Q000601:surgery; D003657:Decision Making; D003663:Decision Trees; D005343:Fibrinolytic Agents / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D008390:Markov Chains; D018803:Models, Economic; D062645:Percutaneous Coronary Intervention / Q000379:methods
chemical_list: D005343:Fibrinolytic Agents