Health Evidence Bulletins - Wales: Questions to assist with the critical
appraisal of an economic analysis (Type IV evidence)
Sources used: Greenhalgh T. How to read a paper: Papers that tell you what things cost (economic analyses). British Medical Journal 1997; 315: 596-599; Drummond MF et al. Users guides to the medical literature. XIII. How to use an article on economic analysis of clinical practice. A.. Are the results valid? Journal of the American Medical Association 1997; 277: 1552-1557; OBrien BJ et al. Users guides to the medical literature. XIII. How to use an article on economic analysis of clinical practice. B. What are the results and will they help me in caring for my patients? Journal of the American Medical Association 1997; 277: 1802-1806.
A What is this paper about?
|1. Is the study relevant to the needs of the Project?|
|2. Is the analysis based on a study that answers a clearly
defined clinical question about an economically important issue?
B/ Do I trust it?
|3. Whose viewpoint are costs and benefits being
|4. Have the interventions being compared been shown to
be clinically effective?
|5. Are the interventions sensible and workable in the
settings where they are likely to be applied? eg
|6. Which method of analysis was used, and was this
C/ What did they find?
|7. How were costs and benefits measured?|
|8. Were incremental rather than absolute benefits
|9. Was the "here and now" given precedence over the
|10. Was a sensitivity analysis performed?|
|11. Were "bottom line" aggregate scores overused?
|12. What are the results of this piece of
Are the authors' conclusions adequately supported by the information cited?
D/ Are the results relevant locally?
|13. Can the results be applied to the local situation?
Consider differences between the local and study populations (eg cultural, geographical, ethical) which could affect the relevance of the study.
|14. Accept for further use as Type IV evidence?||Refer to Team Leader|
Draft Statement (if appropriate):