How Methodologic Differences Affect Results of Economic Analyses: A Systematic Review of Interferon Gamma Release Assays for the Diagnosis of LTBI
How Methodologic Differences Affect Results of Economic Analyses: A Systematic Review of Interferon Gamma Release Assays for the Diagnosis of LTBI
Data
2013
Autores
Oxlade, Olivia
Pinto, Marcia
Trajman, Anete
Menzies, Dick
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS ONE
Resumo
Introduction: Cost effectiveness analyses (CEA) can provide useful information on how to invest limited funds, however
they are less useful if different analysis of the same intervention provide unclear or contradictory results. The objective of
our study was to conduct a systematic review of methodologic aspects of CEA that evaluate Interferon Gamma Release
Assays (IGRA) for the detection of Latent Tuberculosis Infection (LTBI), in order to understand how differences affect study
results.
Methods: A systematic review of studies was conducted with particular focus on study quality and the variability in inputs
used in models used to assess cost-effectiveness. A common decision analysis model of the IGRA versus Tuberculin Skin Test
(TST) screening strategy was developed and used to quantify the impact on predicted results of observed differences of
model inputs taken from the studies identified.
Results: Thirteen studies were ultimately included in the review. Several specific methodologic issues were identified across
studies, including how study inputs were selected, inconsistencies in the costing approach, the utility of the QALY (Quality
Adjusted Life Year) as the effectiveness outcome, and how authors choose to present and interpret study results. When the
IGRA versus TST test strategies were compared using our common decision analysis model predicted effectiveness largely
overlapped.
Implications: Many methodologic issues that contribute to inconsistent results and reduced study quality were identified in
studies that assessed the cost-effectiveness of the IGRA test. More specific and relevant guidelines are needed in order to
help authors standardize modelling approaches, inputs, assumptions and how results are presented and interpreted.
Description
Palavras-chave
Cost-Benefit Analysis, Decision Support Techniques, Humans, Interferon-gamma Release Tests / economics*, Interferon-gamma Release Tests / methods, Latent Tuberculosis / diagnosis*, Latent Tuberculosis / economics*, Latent Tuberculosis / epidemiology, Mass Screening / economics, Mass Screening / methods, Models, Statistical, Quality Control, Quality-Adjusted Life Years, Tuberculin Test / economics, Tuberculin Test / methods
Citação
Oxlade O, Pinto M, Trajman A, Menzies D (2013) How Methodologic Differences Affect Results of Economic Analyses: A Systematic Review of Interferon Gamma Release Assays for the Diagnosis of LTBI. PLoS ONE 8(3): e56044. doi:10.1371/journal.pone.0056044