Chapter 6: Systematic reviews of economic evidence

Objective:This review aims to evaluate the costs and cost-effectiveness of remote patient monitoring for cardiovascular disease in the United States.Introduction:Cardiovascular disease is a leading public health concern in the United States, resulting in a substantial economic burden. Remote patient monitoring has emerged as a viable and valuable care delivery method to improve cardiovascular disease management at home. However, there is limited systematic research of the cost and cost-effectiveness of using remote patient monitoring to manage the disease.Inclusion criteria:This review will consider all studies evaluating the cost of remote patient monitoring for cardiovascular disease management in the United States. The population of interest includes all individuals with various types of chronic cardiovascular disease in the United States.Methods:The search strategy will locate both published and unpublished studies. Systematic searches will be completed in PubMed, Embase, Web of Science, CINAHL, Scopus, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, National Health Service Economic Evaluation Database, and the Cost-Effectiveness Analysis Registry. Two reviewers will independently screen titles and abstracts, followed by a full-text review against the inclusion criteria. Disagreements will be resolved through discussion between all study members. The JBI checklist for economic evaluations will be utilized to evaluate the methodological quality of studies. Data will be extracted using a modified version of the JBI data extraction form for economic evaluations. Reviewers will summarize studies and cost-related metrics. The Dominance Ranking Matrix will be used to synthesize full economic evaluation.Systematic review registration number:PROSPERO CRD42021270621

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“…The proposed systematic review will be conducted in accordance with JBI methodology for systematic reviews of economic evidence. 23…”

Section: Methodsmentioning

confidence: 99%

“…Full economic evaluation studies (eg, CEA, CUA, CBA), as well as partial economic evaluation studies (eg, cost-minimization analysis, cost analysis, cost-description studies, cost-outcome descriptions), will be considered for inclusion in the review. 22,23…”

Section: Types Of Studiesmentioning

confidence: 99%

Cost of remote patient monitoring for cardiovascular disease: a systematic review protocol

Zhang

Peña

Fletcher

et al. 2022

JBI Evidence Synthesis

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“…The Joanna Briggs Institute (JBI) Critical Appraisal Checklist (specific to each study design) was utilized to critically assess the methodology of each article. 21 To further address the study objective, 2 additional questions were included from the JBI Checklist of Economic Evaluations: “Are costs and outcomes measured accurately?” and “Are costs and outcomes valued credibly?” 22 Methodology was assessed individually and discussed by 2 authors, and any disagreements were discussed by the full team for resolution. Next, in pairs of 2, authors (JB, AIK, SBS, TS, ASB, SHG) independently assessed and then compared their findings regarding the methodological quality of the included articles, and any discordance was discussed with a third author and/or the entire study team to reach a consensus.…”

Section: Methodsmentioning

confidence: 99%

Economic Impact and Health Care Utilization Outcomes of Diabetes Self-Management Education and Support Interventions for Persons With Diabetes: A Systematic Review and Recommendations for Future Research

Whitehouse

Haydon-Greatting

Srivastava

et al. 2021

The Science of Diabetes Self-Management and Care

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Purpose Value-driven outcomes are important because health systems determine sustainability of diabetes self-management education and support (DSMES) programming. Health care utilization and clinical outcomes are critical factors when considering the impact of DSMES programs. Objective The aim of this systematic review was to describe studies that report on the economic and health care utilization outcomes of diabetes self-management programs. Methods A systematic literature review was performed in multiple databases. Studies reporting economic and health care utilization outcomes related to DSMES and including 1 or more of the ADCES7 Self-Care BehaviorsTM from January 2006 to May 2020 were included. Eligible articles needed to compare the intervention and comparison group and report on economic impact. The methodological quality was assessed with the Joanna Briggs Institute Critical Appraisal Checklist specific to each individual study design. Results A total of 22 of 14 556 articles published between 2007 and 2020 were included. Cost benefits varied, and there were considerable methodological heterogeneity among design, economic measures, population, perspective, intervention, and biophysical outcomes. Conclusion DSMES interventions may positively impact economic outcomes and/or health care utilization, although not all studies showed consistent benefit. This review highlights an evidence gap, and future health economic evaluations are warranted.

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“…Realizar revisiones sistemáticas de evaluaciones económicas ha sido cuestionado por las limitaciones que se pueden presentar dada la naturaleza de los estudios individuales, con respecto a la fortaleza en la evidencia, por variabilidad en fuentes, uso de recursos, costos, poblaciones, contexto de toma de decisiones, e incluso diferencias dentro de los mismos países (Gomersall et al, 2014(Gomersall et al, , 2015. Lo cual hace improbable poder generar respuestas…”

Section: ¿Qué Es Una Evaluación Económica De Tecnologías En Salud?unclassified

“…En Latinoamérica en Chile se encuentran desarrollando una guía para transferibilidad de evaluaciones económicas de tecnologías en salud, la cual incluye como primer paso realizar una revisión sistemática de estudios previos para valorar similitudes y ajustes necesarios a realizar (PAHO, 2017;RedETSA, 2017) Para realizar revisiones sistemáticas de evaluaciones económicas, aún no se encuentra estandarizada una metodología, y se podría considerar lineamientos de diferentes fuentes como: el capítulo 15 del manual Cochrane, en el cual se dan criterios para incorporación de evidencia económica (Higgins & Green, 2011). Las recomendaciones para revisiones sistemáticas de evaluaciones económicas de la Universidad de York (Akers J et al, 2009), del Instituto Joanna Briggs (Gomersall et al, 2014(Gomersall et al, , 2015, de la revisión sistemática de métodos para revisiones sistemáticas de evaluaciones económicas en salud (Mathes, Walgenbach, Antoine, Pieper, & Eikermann, 2014), u otras publicaciones que proporcionan información de cómo preparar una revisión sistemática de este tipo de estudios (Thielen et al, 2016;van Mastrigt et al, 2016;Wijnen et al, 2016).…”

Section: Revisión Sistemática De Evaluaciones Económicas Y Su Calidadunclassified

Calidad en revisiones sistemáticas de evaluaciones económicas de tecnologías en salud.

2019

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La toma de decisiones en salud tanto desde el punto de vista clínico como administrativo, requiere entre otros aspectos, fundamentarse tanto en la mejor evidencia producto de investigación de las tecnologías sanitarias como en el mejor uso de los escasos recursos económicos con los que usualmente se cuenta. En el ámbito clínico, las revisiones sistemáticas de ensayos clínicos controlados y aleatorizados, aportan información valiosa al sintetizar la mejor evidencia. Por otro lado, las evaluaciones económicas de tecnologías sanitarias son útiles al proporcionar información comparada entre los costos de dicha tecnología, por unidad de desenlace de la enfermedad en términos usualmente de efectividad o de utilidad. Realizar revisiones sistemáticas de evaluaciones económicas de tecnologías sanitarias en principio podría considerarse una muy buena herramienta para toma de decisiones, sin embargo, es importante considerar que las evaluaciones económicas pueden presentar debilidades metodológicas que limitarían su calidad.Las revisiones sistemáticas de ensayos clínicos cuentan con metodologías claras para realizarlas, incluyendo la evaluación de riesgo de sesgo y calidad tanto de los estudios incluidos, como de la misma revisión. En el caso de las evaluaciones económicas aún existe heterogeneidad en la metodología y falta de estandarización en la forma de evaluar su calidad, lo cual afecta el desarrollo de revisiones sistemáticas de evaluaciones económicas. Sin embargo, en la presente revisión se identifican herramientas que pueden servir para evaluar calidad y riesgo de sesgo de evaluaciones económicas, así como también de las mismas revisiones.

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Chapter 6: Systematic reviews of economic evidence

Cited by 3 publications

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Cost of remote patient monitoring for cardiovascular disease: a systematic review protocol

Cost of remote patient monitoring for cardiovascular disease: a systematic review protocol

Economic Impact and Health Care Utilization Outcomes of Diabetes Self-Management Education and Support Interventions for Persons With Diabetes: A Systematic Review and Recommendations for Future Research

Calidad en revisiones sistemáticas de evaluaciones económicas de tecnologías en salud.

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