Systematic review of the quality of economic evaluations in the otolaryngology literature.
OBJECTIVE
To evaluate the quality of economic evaluations published in the otolaryngology--head and neck surgery literature, which will identify methodologic weaknesses that can be improved on in future studies. A secondary objective is to identify factors that may be associated with higher quality economic evaluations.


METHODS
Ovid Medline (including PubMed), Embase, and the National Health Services Economic Evaluation databases.


METHODS
A systematic search was performed of the aforementioned databases according to PRISMA guidelines. The search was performed using otolaryngology key terms combined with the term cost. A manual search of 36 otolaryngology journals was also performed. Included studies were graded using the Quality of Health Economics Studies instrument, a 16-item checklist providing a total quality score of 100.


RESULTS
Fifty studies were identified, and the mean quality rating was 54.7/100 (SD = 30.9). The most commonly omitted methodology components were a lack of discussion of limitations and biases, failure to address the negative outcomes of examined interventions, and a lack of a robust sensitivity analysis. Higher quality economic evaluations were associated with a higher journal impact factor (correlation coefficient r = 0.62, P = .0001), having an author with a PhD in health economics (r = 0.56, P = .0001), and having authors who have published prior economic evaluations (r = 0.46, P = .001).


CONCLUSIONS
Results from this study have demonstrated that there are several methodological domains that can be improved on when publishing economic evaluations in the otolaryngology literature. Authors should follow recommended methodological and reporting guidelines to optimize the transparency and accuracy of the overall conclusions.
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Canada.
C Carrie
CC
Liu
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Canada.
Justin
J
Lui
Departments of Surgery and Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Canada.
Elizabeth
E
Oddone Paolucci
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Canada Lukerudmik@gmail.com.
Luke
L
Rudmik
D003362:Cost-Benefit Analysis / Q000592:standards*; D013517:Otorhinolaryngologic Surgical Procedures / Q000191:economics*; D010506:Periodicals as Topic; D011643:Publishing
cost-effectiveness analysis; cost-utility analysis; economic evaluation; otolaryngology; quality; reporting standards