Why the study?
Do economic evaluations of interventions focused on lowering blood pressure conform to published guidelines for decision-analytic modeling?
Systematic Review (n=13)
Do economic evaluations of interventions focused on lowering blood pressure conform to published guidelines for decision-analytic modeling?
Recent model-based economic evaluations of hypertension interventions show limited compliance with good practice guidelines for decision-analytic modeling, highlighting a need for better handling of structural uncertainty.
Limited compliance with DAM guidelines in hypertension models may undermine cost-effectiveness estimates; leaves open need for better data and structural uncertainty assessment in future CVD evaluations.
Background: Results of previous research have identified the need for further investigation into the compliance with good practice guidelines for current decision-analytic modeling (DAM). Objective: To identify the extent to which recent model-based economic evaluations of interventions focused on lowering the blood pressure (BP) of patients with hypertension conform to published guidelines for DAM in health care using a five-dimension framework developed to assess compliance to DAM guidelines. Methods: A systematic review of English language articles was undertaken to identify published model-based economic evaluations that examined interventions aimed at lowering BP. The review covered the period January 2000 to March 2015 and included the following electronic bibliographic databases: EMBASE and Medline via Ovid interface and the Centre for Reviews and Dissemination’s (CRD) NHS-EED. Data were extracted based on different components of good practice across five dimensions utilizing a framework to assess compliance to DAM guidelines. Results: Thirteen articles were included in this review. The review found limited compliance to good practice DAM guidelines, which was most frequently justified by the lack of data. Conclusions: The assessment of structural uncertainty cannot yet be considered common practice in primary prevention and management of hypertension, and researchers seem to face difficulties with identifying sources of structural uncertainty and then handling them correctly. Additional guidelines are needed to aid researchers in identifying and managing sources of potential structural uncertainty. Adherence to guidelines is not always possible and it does pose challenges, in particular when there are limitations due to data availability that restrict, for example, a validation process.
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Ramos et al. (2016) conducted a systematic review in Hypertension (n=13). Model-based economic evaluations of interventions focused on lowering blood pressure was evaluated on Compliance with good practice guidelines for decision-analytic modeling (DAM). A systematic review of 13 articles found limited compliance to good practice decision-analytic modeling guidelines in economic evaluations of hypertension interventions, often due to lack of data.
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