gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Is GRADE being adopted for the assessment of cost-effectiveness evidence?

Meeting Abstract

Suche in Medline nach

  • J. Hayre - National Institute for Health and Clinical Excellence, Manchester, United Kingdom
  • P. Kandaswamy - National Institute for Health and Clinical Excellence, Manchester, United Kingdom
  • M. Dzingina - National Institute for Health and Clinical Excellence, Manchester, United Kingdom

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP018

doi: 10.3205/12gin130, urn:nbn:de:0183-12gin1308

Veröffentlicht: 10. Juli 2012

© 2012 Hayre et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Background: The use of cost-effectiveness estimates is increasingly being incorporated into decision making for health. NICE recommends the use of a ‘modified’ GRADE profile for assessing cost-effectiveness evidence in clinical guidelines. Various other GRADE inspired profiles have also been suggested and adopted for cost-effectiveness analyses. However, because of these modifications, the methodology used to assess the quality of this evidence remains unclear.

Objectives: To determine the rate of adoption of ‘modified’ GRADE systems.

Methods: A search for ‘modified’ evidence profiles for cost-effectiveness was conducted for all public and clinical health guidance from organizations that have endorsed or used GRADE since 2008. Descriptive statistics such as clinical area, question type and how frequently GRADE was used by each organization was collected. Data on the quality criteria used to assess the quality of analyses was also collected. Furthermore, economic models were examined to determine whether GRADE was used to assess model parameters.

Results: Preliminary results suggest few health organisations use cost-effectiveness results in decision making. In the United Kingdom, the use of GRADE for this evidence remains scarce. There was variation in GRADE inspired economic evidence profile usage, for example, a different set of GRADE criteria was used by different organizations. Results suggest that GRADE assessment of economic model inputs was infrequently conducted.

Discussion: Assessing the quality of cost-effectiveness evidence using a transparent formalised method is critical for decision makers.

Implications for guideline developers: Methodological standardization of GRADE for the appraisal of cost-effectiveness evidence is required to ensure transparency and consistency.