A systematic review of model-based economic evaluations of diagnostic and therapeutic strategies for lower extremity artery disease

Anil Vaidya; Manuela A. Joore; Arina J. ten Cate-Hoek; Marie-Claire Kleinegris; Hugo ten Cate; Johan L. Severens

doi:10.1160/TH13-06-0498

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2014; 111(01): 19-28
DOI: 10.1160/TH13-06-0498

Review Article

Schattauer GmbH

A systematic review of model-based economic evaluations of diagnostic and therapeutic strategies for lower extremity artery disease

Anil Vaidya

¹Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre Maastricht, The Netherlands

²School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands

,

Manuela A. Joore

¹Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre Maastricht, The Netherlands

²School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands

,

Arina J. ten Cate-Hoek

³Laboratory for Clinical Thrombosis and Haemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands

,

Marie-Claire Kleinegris

³Laboratory for Clinical Thrombosis and Haemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands

,

Hugo ten Cate

³Laboratory for Clinical Thrombosis and Haemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands

,

Johan L. Severens

⁴Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands

› Author Affiliations

Abstract

Summary

Lower extremity artery disease (LEAD) is a sign of wide spread atherosclerosis also affecting coronary, cerebral and renal arteries and is associated with increased risk of cardiovascular events. Many economic evaluations have been published for LEAD due to its clinical, social and economic importance. The aim of this systematic review was to assess modelling methods used in published economic evaluations in the field of LEAD. Our review appraised and compared the general characteristics, model structure and methodological quality of published models. Electronic databases MEDLINE and EMBASE were searched until February 2013 via OVID interface. Cochrane database of systematic reviews, Health Technology Assessment database hosted by National Institute for Health research and National Health Services Economic Evaluation Database (NHSEED) were also searched. The methodological quality of the included studies was assessed by using the Philips’ checklist. Sixteen model-based economic evaluations were identified and included. Eleven models compared therapeutic health technologies; three models compared diagnostic tests and two models compared a combination of diagnostic and therapeutic options for LEAD. Results of this systematic review revealed an acceptable to low methodological quality of the included studies. Methodological diversity and insufficient information posed a challenge for valid comparison of the included studies. In conclusion, there is a need for transparent, methodologically comparable and scientifically credible modelbased economic evaluations in the field of LEAD. Future modelling studies should include clinically and economically important cardiovascular outcomes to reflect the wider impact of LEAD on individual patients and on the society.

Keywords

Lower extremity artery disease - economic evaluation - decision analytic model - systematic review

Full Text

References

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