title: Economic evaluations of guideline-based or strategic interventions for the prevention or treatment of chronic wounds.
abstract: BACKGROUND
  Costs of chronic wound care are significant, but systematic reviews of cost-effectiveness studies regarding guideline-based or strategic interventions are scarce.
  
  
  OBJECTIVE
  Our objectives were to assess/compare the cost effectiveness of new interventions/systems designed to improve the prevention/treatment of chronic wounds in adult populations against current care and provide decision makers with information on which to base future interventions for chronic wound management.
  
  
  METHODS
  Data sources included PubMed, Scopus, HTA, and NHS EED.
  
  
  METHODS
  We included comparative health economic evaluations of interventions published in English designed to prevent or treat adult chronic wounds that were guideline-based or strategic in nature and from which an incremental cost-effectiveness ratio or incremental net health benefit was reported or could be calculated.
  
  
  METHODS
  Study and model characteristics and outcomes were extracted into pre-designed tables. Quality assessment of studies was based on literature-reported methods. Studies were assigned strength of evidence ratings and recommendation level for decision makers.
  
  
  RESULTS
  A total of 16 health economic evaluations were included, of which ten were trial based and six were wholly model based. Only three studies had high, and five studies moderate, strength of evidence and were recommended for decision makers. All studies had some shortcomings regarding time horizon, costs, effectiveness units, and methodological reporting. Two studies had major flaws.
  
  
  CONCLUSIONS
  Limitations include missed studies published in non-English languages or not cited in searched databases; judgment bias in assessing studies.
  
  
  CONCLUSIONS
  Few well conducted cost-effectiveness studies exist to guide decision makers regarding guideline-based or strategic interventions for chronic wounds.
authors.affiliation: Strategic Solutions, Inc., 1143 Salsbury Ave, Cody, WY, 82414, USA, mcarter@strategic-solutions-inc.com.
authors.forename: Marissa J
authors.initials: MJ
authors.lastname: Carter
mesh_terms: D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D006801:Humans; D017059:Models, Econometric; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics*; D014947:Wounds and Injuries / Q000191:economics / Q000517:prevention & control / Q000628:therapy*