gms | German Medical Science

Background/research question: Systematic reviews of health economic evaluations (SR-HEs) can be valuable to

1.

inform the development of an own economic model;

2.

identify the most relevant studies for a particular decision; and

3.

identify the implicated economic trade-offs.

Despite applicability concerns, a strong argument for performing a SR-HE instead of a novel economic evaluation is that usually less staff and time resources are needed.

We aimed at providing a detailed overview of the characteristics and applied methods in recently published SR-HEs.

Methods: We searched MEDLINE (03/2017) for SR-HEs published since 2015 using validated search filters. We included studies that performed a systematic review of full economic evaluations and searched at least one electronic database. We extracted data in a standardized, beforehand piloted form that was deduced from the items of the PRISMA and CHEERS checklists. Data were extracted by one reviewer and a 10% random sample was verified by a second. We prepared descriptive statistical measures (e.g. median, ranges) to describe the SR-HEs. Data were synthesized in a structured narrative way.

Results: We included 202 SR-HEs. We identified similarities especially in the methods for information retrieval. Study selection, data extraction and quality assessment were frequently performed without measures to reduce errors (e.g. independent study selection). 30% and 81% of authors did not systematically assess methodological quality and transferability, respectively. A wide range of different tools was applied for critical appraisal. Moreover, the reporting of included economic evaluations and the synthesis of their results showed strong variations.

Conclusions: Overall, we identified few common features in the applied methods for SR-HEs. The information retrieval processes were most homogenous although many studies did not use validated search filters. For the other systematic review steps the methodological approaches varied. In particular, important challenges seem to be the methodological quality and transferability assessment as well as presentation and (quantitative) synthesis of results. Efforts are needed for increasing standardization, quality of applied methods and reporting of SR-HEs.

Competing interests: Nothing to declare.