From Effectiveness to Efficiency? An Introduction to Evidence‐Based Decisions and Economics

Mugford, Miranda; Shemilt, Ian; Vale, Luke; Marsh, Kevin; Donaldson, Cam; Mallender, Jacqueline

doi:10.1002/9781444320398.ch1

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…Cahill et al [ 20 ] also used efficacy estimates from laboratory investigation data [ 30 ]. These estimates may have limited applicability to measuring real-world effectiveness [ 31 ]. Dan et al [ 12 ] estimated baseline intervention effectiveness rates of 50, 80 and 90 % as protective equipment (including masks) and isolation precautions were increased.…”

Section: Resultsmentioning

confidence: 99%

“…One key recommendation is that future economic analyses should attempt to apply clinical mask/respirator efficacy data, preferably from clinical trials, where this data is deemed applicable to the infectious agent, intervention and setting, rather than using estimations derived from expert opinion or laboratory testing studies [ 31 ]. In some cases this may not be possible, for example, it is not appropriate to extrapolate clinical trial results for respiratory viruses to tuberculosis and for ethical reasons, randomised trial data cannot be collected on the effectiveness of a respirator intervention in HCWs for tuberculosis prevention.…”

Section: Discussionmentioning

confidence: 99%

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Review of economic evaluations of mask and respirator use for protection against respiratory infection transmission

2015

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BackgroundThere has been increasing debate surrounding mask and respirator interventions to control respiratory infection transmission in both healthcare and community settings. As decision makers are considering the recommendations they should evaluate how to provide the most efficient protection strategies with minimum costs. The aim of this review is to identify and evaluate the existing economic evaluation literature in this area and to offer advice on how future evaluations on this topic should be conducted.MethodsWe searched the Scopus database for all literature on economic evaluation of mask or respirator use to control respiratory infection transmission. Reference lists from the identified studies were also manually searched. Seven studies met our inclusion criteria from the initial 806 studies identified by the search strategy and our manual search.ResultsFive studies considered interventions for seasonal and/or pandemic influenza, with one also considering SARS (Severe Acute Respiratory Syndrome). The other two studies focussed on tuberculosis transmission control interventions. The settings and methodologies of the studies varied greatly. No low-middle income settings were identified. Only one of the reviewed studies cited clinical evidence to inform their mask/respirator intervention effectiveness parameters. Mask and respirator interventions were generally reported by the study authors to be cost saving or cost-effective when compared to no intervention or other control measures, however the evaluations had important limitations.ConclusionsGiven the large cost differential between masks and respirators, there is a need for more comprehensive economic evaluations to compare the relative costs and benefits of these interventions in situations and settings where alternative options are potentially applicable. There are at present insufficient well conducted cost-effectiveness studies to inform decision-makers on the value for money of alternative mask/respirator options.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Review of economic evaluations of mask and respirator use for protection against respiratory infection transmission

2015

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“…The material contained in the edited volume that is summarized in this article 4 represents a considerable step forward in understanding how the activities and outputs of economic analysis, evidence synthesis and systematic review may be used in combination to address policy problems in the fields of health care, social welfare, education and criminal justice. However, as the introductory and final chapters of the edited volume indicate, exploration of these issues inevitably identifies areas where further research is required 70, 81, 103.…”

Section: Determining Future Research Prioritiesmentioning

confidence: 99%

Evidence synthesis, economics and public policy

et al. 2010

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Systematic reviews and syntheses of evidence are increasingly used to inform public policy decisions. Growing budgetary pressures mean that decision makers often need to consider evidence on the costs and efficiency of alternatives as well as their effects. There are a number of methodological challenges in the identification, appraisal, synthesis, interpretation and use of economic evidence. This article draws on a recently published edited volume to review the latest developments, proposals and controversies in these aspects of economic evidence synthesis methodology. It focuses on two broad classes of approach: systematic review to summarize and compare the findings of existing economic analyses and synthesis of new economic results using decision models. The availability and scope of economic evidence is currently limited in many fields, but improving. Increased engagement between economists, the wider evidence synthesis community, and decision makers is needed to improve both the production and use of economic evidence. Further research to improve the evidence base that underpins application of economic evidence synthesis methodology will need to embrace a broader range of methods than economic evaluation and systematic review alone. Copyright © 2010 John Wiley & Sons, Ltd.

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MST With Conduct Disordered Youth in Sweden: Costs and Benefits After 2 Years

Olsson

2009

Research on Social Work Practice

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Objectives: The purpose of this study was to investigate the costs and benefits associated with multisystemic therapy (MST) for conduct disordered youth, 2 years following intake. Methods: The study employed a secondary analysis of 156 youth enrolled in a randomized trial assessing the psychosocial and behavioral outcomes of MST. Results: MST cost on average 105,400 SEK per youth. MST was associated with a direct benefit to participants of 1,000 SEK per youth and positively impacted the use of nonplacement downstream interventions for a benefit of 62,100 SEK per youth. These benefits did not offset the cost of MST. Conclusions: MST was associated with a net loss to society after 2 years of 44,500 SEK per youth.

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From Effectiveness to Efficiency? An Introduction to Evidence‐Based Decisions and Economics

Cited by 3 publications

References 12 publications

Review of economic evaluations of mask and respirator use for protection against respiratory infection transmission

Review of economic evaluations of mask and respirator use for protection against respiratory infection transmission

Evidence synthesis, economics and public policy

MST With Conduct Disordered Youth in Sweden: Costs and Benefits After 2 Years

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