title: A methodological analysis of the plastic surgery cost-utility literature using established guidelines.
abstract: BACKGROUND
  Cost-utility studies, common in medicine, are rare within plastic surgery despite their capability of measuring the value of procedures by considering the societal costs of improving quality of life. The objectives of this study were to analyze the design quality of the plastic surgery cost-utility literature and to identify areas of needed improvement for future studies.
  
  
  METHODS
  A scoring tool was constructed based on the Recommendations of the Panel on Cost-Effectiveness in Health and Medicine. A PubMed search through October of 2012 was conducted for English-language plastic surgery utility studies. Articles were selected using two inclusion criteria and evaluated using the scoring tool.
  
  
  RESULTS
  A 9-point scoring tool was created, and 37 publications were selected. Their average score was 3 out of 9 points. Thirty studies (81 percent) used population preferences in utility measurements. Fifteen studies (41 percent) measured costs, but only four (11 percent) included indirect costs and only five (14 percent) applied discount rates to calculate the value of treatments over time. Three studies (8 percent) earned zero points. The highest scoring study earned 8 points.
  
  
  CONCLUSIONS
  The identified studies manifest the potential of cost-utility analyses in plastic surgery. Nonetheless, they are inconsistent in applying established cost-utility guidelines, especially in measuring costs and conducting recommended sensitivity analysis. Following this simple scoring tool can help future studies achieve some necessary improvements.
authors.affiliation: Boston, Mass.; and Montreal, Quebec, Canada From the Massachusetts General Hospital; Harvard Medical School; and the Faculty of Medicine, McGill University.
authors.forename: Oren
authors.initials: O
authors.lastname: Tessler
authors.forename: David
authors.initials: D
authors.lastname: Mattos
authors.forename: Joshua
authors.initials: J
authors.lastname: Vorstenbosch
authors.forename: Daniel
authors.initials: D
authors.lastname: Jones
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Winograd
authors.forename: Eric C
authors.initials: EC
authors.lastname: Liao
authors.forename: William G
authors.initials: WG
authors.lastname: Austen
mesh_terms: D003362:Cost-Benefit Analysis / Q000592:standards*; D017408:Guidelines as Topic; D006801:Humans; D010506:Periodicals as Topic; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D019651:Plastic Surgery Procedures / Q000191:economics*; D013518:Surgery, Plastic / Q000191:economics*