The role of health economic evidence in clinical practice guidelines for colorectal cancer: a comparative analysis across countries.

IF 1.9 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Xiaoyu Yan, Yue Wang, Aixia Ma, Hongchao Li
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引用次数: 0

Abstract

Aim: Colorectal cancer (CRC) is among the most prevalent malignancies globally and causes massive resource consumption and economic burden. Health economic evidence (HEE) has been used in clinical practice guidelines (CPGs) for cancer to facilitate the rational allocation of health resources. However, in certain guideline development organizations, HEE is not yet utilized as a formal decision-making criterion. This study aimed to compare the discrepancies in the utilization of health economics as evidence in CRC CPGs across different countries and review specific features of economic evidence concerning the guidelines' applicability. Materials & methods: A systematic review was conducted using databases including Medline, Embase, CNKI, WanFang, and other guidelines databases to identify CPGs for CRC published in English or Chinese from January 2017 to September 2023. Data on the incorporation and application of HEE were extracted, and the method and quality of cost-effectiveness analysis (CEA) studies were evaluated. Descriptive analyses were used to summarize the results. Results: Out of 53 CPGs from 14 countries, most originated from the USA (n = 17 of 53 [32%]) and Canada (n = 9 of 53 [17%]). Sixty-eight percent (36/53) considered cost justification, and 57% (30/53) incorporated health economics studies as evidence. The included HEE cited in CPGs ranged from 1990 to 2021 and were not aligned with the countries in which the guidelines were issued. Among these CEA studies, 52% (26/50) were related to screening strategies, and 32% (16/50) pertained to treatment measures. The Markov model was the most frequently used (n = 27 of 50 [54%]). Based on the CHEQUE tool, the methodological quality of these CEA studies was inadequate in areas such as multiple data sources, approaches to select data sources, assessing the quality of data, and relevant equity or distribution. Conclusion: In summary, 57% of guidelines incorporated health economics studies as evidence, with a variation between different countries. The included HEE still had deficiencies in methodology and reporting quality. In the future, it is suggested that health economics research should use a standardized methodology and reporting approach to assist in clinical decision making.

卫生经济证据在结直肠癌临床实践指南中的作用:各国的比较分析
目的:结直肠癌(CRC)是全球最常见的恶性肿瘤之一,造成巨大的资源消耗和经济负担。卫生经济证据(HEE)已被用于癌症临床实践指南(CPGs),以促进卫生资源的合理分配。然而,在某些指导方针制定组织中,HEE尚未被用作正式的决策标准。本研究旨在比较不同国家在CRC CPGs中使用卫生经济学作为证据的差异,并回顾有关指南适用性的经济证据的具体特征。材料与方法:采用Medline、Embase、CNKI、万方等指南数据库进行系统综述,筛选2017年1月至2023年9月发表的中英文CRC cpg。我们提取了有关HEE纳入和应用的数据,并对成本-效果分析(CEA)研究的方法和质量进行了评价。描述性分析用于总结结果。结果:来自14个国家的53例cpg中,大多数来自美国(53例中有17例[32%])和加拿大(53例中有9例[17%])。68%(36/53)考虑成本合理性,57%(30/53)将卫生经济学研究作为证据。CPGs中引用的包括HEE的范围从1990年到2021年,与发布指南的国家不一致。在这些CEA研究中,52%(26/50)与筛查策略有关,32%(16/50)与治疗措施有关。最常用的是马尔可夫模型(n = 27 / 50[54%])。基于check工具,这些CEA研究的方法学质量在多个数据源、选择数据源的方法、评估数据质量以及相关公平性或分布等方面存在不足。结论:总的来说,57%的指南将卫生经济学研究作为证据,不同国家之间存在差异。纳入的HEE在方法和报告质量方面仍存在不足。在未来,建议卫生经济学研究应采用标准化的方法和报告方法,以协助临床决策。
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来源期刊
Journal of comparative effectiveness research
Journal of comparative effectiveness research HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.50
自引率
9.50%
发文量
121
期刊介绍: Journal of Comparative Effectiveness Research provides a rapid-publication platform for debate, and for the presentation of new findings and research methodologies. Through rigorous evaluation and comprehensive coverage, the Journal of Comparative Effectiveness Research provides stakeholders (including patients, clinicians, healthcare purchasers, and health policy makers) with the key data and opinions to make informed and specific decisions on clinical practice.
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