Calidad en revisiones sistemáticas de evaluaciones económicas de tecnologías en salud

Carolina Castañeda Guerrero, Fernando De la Hoz Restrepo, Nelson Alvis Guzmán

DOI: https://doi.org/10.32997/2463-0470-vol.27-num.3-2019-2583

Resumen

La toma de decisiones en salud tanto desde el punto de vista clínico como administrativo, requiere entre otros aspectos, fundamentarse tanto en la mejor evidencia producto de investigación de las tecnologías sanitarias como en el mejor uso de los escasos recursos económicos con los que usualmente se cuenta. En el ámbito clínico, las revisiones sistemáticas de ensayos clínicos controlados y aleatorizados, aportan información valiosa al sintetizar la mejor evidencia. Por otro lado, las evaluaciones económicas de tecnologías sanitarias son útiles al proporcionar información comparada entre los costos de dicha tecnología, por unidad de desenlace de la enfermedad en términos usualmente de efectividad o de utilidad. Realizar revisiones sistemáticas de evaluaciones económicas de tecnologías sanitarias en principio podría considerarse una muy buena herramienta para toma de decisiones, sin embargo, es importante considerar que las evaluaciones económicas pueden presentar debilidades metodológicas que limitarían su calidad.

Las revisiones sistemáticas de ensayos clínicos cuentan con metodologías claras para realizarlas, incluyendo la evaluación de riesgo de sesgo y calidad tanto de los estudios incluidos, como de la misma revisión. En el caso de las evaluaciones económicas aún existe heterogeneidad en la metodología y falta de estandarización en la forma de evaluar su calidad, lo cual afecta el desarrollo de revisiones sistemáticas de evaluaciones económicas. Sin embargo, en la presente revisión se identifican herramientas que pueden servir para evaluar calidad y riesgo de sesgo de evaluaciones económicas, así como también de las mismas revisiones.


Palabras clave

Tecnologías sanitarias; tecnologías en salud; revisiones sistemáticas; evaluaciones económicas; calidad; evaluación calidad;

Texto completo:

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Referencias

Adarkwah, C. C., van Gils, P. F., Hiligsmann, M., & Evers, S. M. (2016). Risk of bias in model-based economic evaluations: the ECOBIAS checklist. Expert Rev Pharmacoecon Outcomes Res, 16(4), 513-523. doi: 10.1586/14737167.2015.1103185

Akers J, Aguiar-Ibáñez R, Baba-Akbari A, Beynon S, Booth A, Burch J, . . . Fonseca T. (2009). Systematic Reviews of Economic EvaluationsSystematic Reviews. CRD´s guidance for undertaking reviews in health care.: Centre for Reviews and Dissemination, University of York. Retrieved from http://www.york.ac.uk/crd/SysRev/!SSL!/WebHelp/SysRev3.htm

Anderson, R. (2010). Systematic reviews of economic evaluations: utility or futility? Health Econ, 19(3), 350-364. doi: 10.1002/hec.1486

Atehortua, S., Ceballos, M., Gaviria, C. F., & Mejia, A. (2013). [Quality assessment of economic evaluations in health care in Colombia: a systematic review]. Biomedica, 33(4), 615-630.

Atkins, D., Best, D., Briss, P. A., Eccles, M., Falck-Ytter, Y., Flottorp, S., . . . Zaza, S. (2004). Grading quality of evidence and strength of recommendations. BMJ, 328(7454), 1490. doi: 10.1136/bmj.328.7454.1490

Augustovski, F., García Martí, S., & Pichon-Riviere, A. (2013). Estándares Consolidados de Reporte de Evaluaciones Económicas Sanitarias: Versión en Español de la Lista de Comprobación CHEERS. Value in Health Regional Issues, 2(3), 338-341. doi: http://dx.doi.org/10.1016/j.vhri.2013.10.004

Borgerson, K. (2009). Valuing evidence: bias and the evidence hierarchy of evidence-based medicine. Perspect Biol Med, 52(2), 218-233. doi: 10.1353/pbm.0.0086

Briggs A, C. K., Sculper M,. (2007). Decision modelling for health economic evaluation. Oxford UK: Oxford University Press.

Brouwer, W. B., Culyer, A. J., van Exel, N. J., & Rutten, F. F. (2008). Welfarism vs. extra-welfarism. J Health Econ, 27(2), 325-338. doi: 10.1016/j.jhealeco.2007.07.003

Brunetti, M., Shemilt, I., Pregno, S., Vale, L., Oxman, A. D., Lord, J., . . . Schunemann, H. J. (2013). GRADE guidelines: 10. Considering resource use and rating the quality of economic evidence. J Clin Epidemiol, 66(2), 140-150. doi: 10.1016/j.jclinepi.2012.04.012

Cochrane Website. Cochrane Collaboration. Retrieved Marzo 7, 2019, from https://www.cochrane.org/about-us

Cooper, N., Coyle, D., Abrams, K., Mugford, M., & Sutton, A. (2005). Use of evidence in decision models: an appraisal of health technology assessments in the UK since 1997. J Health Serv Res Policy, 10(4), 245-250. doi: 10.1258/135581905774414187

Chaikledkaew, U., & Kittrongsiri, K. (2014). Quality assessment of health economic evaluation. J Med Assoc Thai, 97 Suppl 5, S113-118.

Drummond, M., Barbieri, M., Cook, J., Glick, H. A., Lis, J., Malik, F., . . . Severens, J. (2009). Transferability of economic evaluations across jurisdictions: ISPOR Good Research Practices Task Force report. Value Health, 12(4), 409-418. doi: 10.1111/j.1524-4733.2008.00489.x

Drummond, M. F., & Jefferson, T. O. (1996). Guidelines for authors and peer reviewers of economic submissions to the BMJ. The BMJ Economic Evaluation Working Party. BMJ, 313(7052), 275-283.

Drummond MF, S. M., Claxton K, Stoddart GL, Torrance GW (2015). Methods for the Economic Evaluation of Health Care Programmes. Oxford - United Kingdom.

EunetHTA. (2015). Methods for health economic evaluations - A guideline based on current practices in Europe. Retrieved marzo 23, 2019, from https://www.eunethta.eu/wpcontent/uploads/2018/03/Methods_for_health_economic_evaluations.pdf

Evers, S., Goossens, M., de Vet, H., van Tulder, M., & Ament, A. (2005). Criteria list for assessment of methodological quality of economic evaluations: Consensus on Health Economic Criteria. Int J Technol Assess Health Care, 21(2), 240-245.

García Fariñas, A., García Rodríguez, J. F., Gálvez González, A. M., & Jimenez López, G. (2016). Calidad metodológica de las evaluaciones económicas completas, publicadas en revistas médicas cubanas (1999-2014). Revista Cubana de Salud Pública, 42, 183-192.

Gomersall, J. S., Jadotte, Y. T., Xue, Y., Lockwood, S., Riddle, D., & Preda, A. (2014). The Systematic Review of Economic Evaluation Evidence.: The Joanna Briggs Institute Reviewers’ Manual 2014.

Gomersall, J. S., Jadotte, Y. T., Xue, Y., Lockwood, S., Riddle, D., & Preda, A. (2015). Conducting systematic reviews of economic evaluations. Int J Evid Based Healthc, 13(3), 170-178. doi: 10.1097/xeb.0000000000000063

Gray, A. M. C., P.M.; Wolstenholme, J.L.; Wordsworth S. (2011). Applied Methods of Cost-effectiveness Analysis in Health Care. Oxford United Kingdom: Oxford University Press.

Herner, M. (2019). Perfect Top of the Evidence Hierarchy Pyramid, Maybe Not So Perfect: lessons learned by a novice researcher engaging in a meta-analysis project. BMJ Evid Based Med. doi: 10.1136/bmjebm-2018-111141

Higgins, J., & Green, S. (Producer). (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Retrieved from www.cochrane-handbook.org

Howick, J., Chalmers, L., Glasziou, P., Greenhalgh, T., Heneghan, C., Liberati, A., . . . Hodgkinson, M. (2011). The Oxford Levels of Evidence 2. Retrieved Marzo 12, 2019, from https://www.cebm.net/index.aspx?o=5653

Husereau, D., Drummond, M., Petrou, S., Carswell, C., Moher, D., Greenberg, D., . . . Loder, E. (2013). Consolidated Health Economic Evaluation Reporting Standards (CHEERS)-- explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value Health, 16(2), 231-250. doi: 10.1016/j.jval.2013.02.002

INHATA. The International Network of Agencies for Health Technology Assessment. Retrieved Marzo 5, 2019, from http://www.inahta.org/

ISPOR. (2018). Pharmacoeconomic Guidelines Around the World. Retrieved Marzo 18, 2019 from https://tools.ispor.org/peguidelines/

Langer, A. (2012). A framework for assessing Health Economic Evaluation (HEE) quality appraisal instruments. BMC Health Serv Res, 12, 253. doi: 10.1186/1472-6963-12-253

Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P., . . . Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Plos Med, 6(7), e1000100. doi: 10.1371/journal.pmed.1000100

Luhnen, M., Prediger, B., Neugebauer, E. A. M., & Mathes, T. (2019). Systematic reviews of health economic evaluations: A structured analysis of characteristics and methods applied. doi: 10.1002/jrsm.1342

Manterola, C., Asenjo-Lobos, C., & Otzen, T. (2014). [Hierarchy of evidence: levels of evidence and grades of recommendation from current use]. Rev Chilena Infectol, 31(6), 705-718. doi: 10.4067/s0716-10182014000600011

Mathes, T., Walgenbach, M., Antoine, S. L., Pieper, D., & Eikermann, M. (2014). Methods for systematic reviews of health economic evaluations: a systematic review, comparison, and synthesis of method literature. Med Decis Making, 34(7), 826-840. doi: 10.1177/0272989x14526470

Murad, M. H., Asi, N., Alsawas, M., & Alahdab, F. (2016). New evidence pyramid. 21(4), 125-127. doi: 10.1136/ebmed-2016-110401

Ng, Y. K. (2004). Welfare Economics: Towards a More complete Analysis. New York - USA: Palgrave Macmillan.

PAHO, T. V. (Producer). (2017, Marzo 20 de 2019). Webinar Transferibilidad de evaluaciones económicas. Retrieved from https://www.youtube.com/watch?v=oE1N35d5mEw

Philips, Z., Ginnelly, L., Sculpher, M., Claxton, K., Golder, S., Riemsma, R., . . . Glanville, J. (2004). Review of guidelines for good practice in decision-analytic modelling in health technology assessment. Health Technol Assess, 8(36), iii-iv, ix-xi, 1-158.

Pichon-Riviere, A., Augustovski, F., Garcia Marti, S., Sullivan, S. D., & Drummond, M. (2012). Transferability of health technology assessment reports in Latin America: an exploratory survey of researchers and decision makers. Int J Technol Assess Health Care, 28(2), 180-186. doi: 10.1017/s0266462312000074

Pieper, D., Koensgen, N., Breuing, J., Ge, L., & Wegewitz, U. (2018). How is AMSTAR applied by authors - a call for better reporting. BMC Med Res Methodol, 18(1), 56. doi: 10.1186/s12874-018-0520-z

Pollock, M., Fernandes, R. M., Becker, L. A., Featherstone, R., & Hartling, L. (2016). What guidance is available for researchers conducting overviews of reviews of healthcare interventions? A scoping review and qualitative metasummary. Syst Rev, 5(1), 190. doi: 10.1186/s13643-016-0367-5

Pollock, M., Fernandes, R. M., & Hartling, L. (2017). Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions. BMC Med Res Methodol, 17(1), 48. doi: 10.1186/s12874-017-0325-5

RedETSA (Producer). (2017, Marzo 18 2019). Transferibilidad de evaluaciones económicas. Retrieved from http://redetsa.org/wp/?p=3994

Rehfuess, E. A., Stratil, J. M., Scheel, I. B., Portela, A., Norris, S. L., & Baltussen, R. (2019). The WHOINTEGRATE evidence to decision framework version 1.0: integrating WHO norms and values and a complexity perspective. BMJ Glob Health, 4(Suppl 1), e000844. doi: 10.1136/bmjgh-2018-000844

Rezapour, A., Jafari, A., Mirmasoudi, K., & Talebianpour, H. (2017). Quality Assessment of Published Articles in Iranian Journals Related to Economic Evaluation in Health Care Programs Based on Drummond’s Checklist: A Narrative Review. Iran J Med Sci, 42(5), 427-436.

Sackett, D. L., Rosenberg, W. M., Gray, J. A., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: what it is and what it isn’t. BMJ, 312, 71-72.

Shea, B. J., Grimshaw, J. M., Wells, G. A., Boers, M., Andersson, N., Hamel, C., . . . Bouter, L. M. (2007). Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol, 7, 10. doi: 10.1186/1471-2288-7-10

Shea, B. J., Hamel, C., Wells, G. A., Bouter, L. M., Kristjansson, E., Grimshaw, J., . . . Boers, M. (2009). AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol, 62(10), 1013-1020. doi: 10.1016/j.jclinepi.2008.10.009

Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., . . . Henry, D. A. (2017). AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or nonrandomised studies of healthcare interventions, or both. BMJ, 358, j4008. doi: 10.1136/bmj.j4008

Shemilt, I., McDaid, D., Marsh, K., Henderson, C., Bertranou, E., Mallander, J., . . . Vale, L. (2013). Issues in the incorporation of economic perspectives and evidence into Cochrane reviews. Syst Rev, 2, 83. doi: 10.1186/2046-4053-2-83

SIGN, G. (2011). SIGN 50 A guideline developer’s handbook. Scottish Intercollegiate Guidelines Network SIGN Retrieved from https://www.sign.ac.uk/assets/sign50_2011.pdf

Smith, V., Devane, D., Begley, C. M., & Clarke, M. (2011). Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol, 11(1), 15. doi: 10.1186/1471-2288-11-15

Soto-Alvarez, J. (2012). Evaluación económica de medicamentos y tecnologías sanitarias: Principios, métodos y aplicaciones en política sanitaria. (S. A. U. Springer SBM Spain Ed.). Madrid, España.

Tan-Torres, E., Baltusen, R., Adam, T., Hutubessy, R., Acharya, A., Evans, D., & Murray, C. J. L. (2003). Making choices in health: WHO Guide to Cost-effectiveness Analysis. from https://www.who.int/choice/publications/p_2003_generalised_cea.pdf

Thielen, F. W., Van Mastrigt, G., Burgers, L. T., Bramer, W. M., Majoie, H., Evers, S., & Kleijnen, J. (2016). How to prepare a systematic review of economic evaluations for clinical practice guidelines: database selection and search strategy development (part 2/3). Expert Rev Pharmacoecon Outcomes Res, 16(6), 705-721. doi: 10.1080/14737167.2016.1246962

Thulliez, M., Angoulvant, D., Pisella, P. J., & Bejan-Angoulvant, T. (2018). Overview of Systematic Reviews and Meta-analyses on Systemic Adverse Events Associated With Intravitreal Anti-Vascular Endothelial Growth Factor Medication Use. JAMA Ophthalmol, 136(5), 557-566. doi: 10.1001/jamaophthalmol.2018.0002

Urrutia, G., & Bonfill, X. (2010). [PRISMA declaration: a proposal to improve the publication of systematic reviews and meta-analyses]. Med Clin (Barc), 135(11), 507-511. doi: 10.1016/j.medcli.2010.01.015

van Mastrigt, G. A., Hiligsmann, M., Arts, J. J., Broos, P. H., Kleijnen, J., Evers, S. M., & Majoie, M. H. (2016). How to prepare a systematic review of economic evaluations for informing evidence-based healthcare decisions: a five-step approach (part 1/3). Expert Rev Pharmacoecon Outcomes Res, 16(6), 689-704. doi: 10.1080/14737167.2016.1246960

Walker, D. G., Wilson, R. F., Sharma, R., Bridges, J., Niessen, L., Bass, E. B., & Frick, K. (2012). Best Practices for Conducting Economic Evaluations in Health Care: A Systematic Review of Quality Assessment Tools: The Johns Hopkins University Evidence-based Practice Center.

WHO, W. H. O. (2008). WHO guide for standardization of economic evaluations of immunization programmes (V. a. B. Department of Immunization, Trans.). Geneva, Switzerland: World Health Organization.

Wijnen, B., Van Mastrigt, G., Redekop, W. K., Majoie, H., De Kinderen, R., & Evers, S. (2016). How to prepare a systematic review of economic evaluations for informing evidence-based healthcare decisions: data extraction, risk of bias, and transferability (part 3/3). Expert Rev Pharmacoecon Outcomes Res, 16(6), 723-732. doi: 10.1080/14737167.2016.1246961


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