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40 Hyperbaric Oxygenation Therapy KCE Reports 74
4 REVIEW OF ECONOMIC STUDIES
4.1 INTRODUCTION
In this chapter we provide a systematic literature review and a detailed and critical
appraisal of results. The objective is to determine if adjuvant HBOT is a cost-effective
option compared with standard care for several indications.
4.2 METHODS
4.2.1 Literature search strategy
A comprehensive review of the literature was undertaken to identify all literature that
may provide evidence with regard to the cost effectiveness of HBOT. Websites of HTA
institutes and electronic databases were searched.
4.2.1.1 HTA institute reports
As a starting point, websites of HTA institutes were consulted. The search of
INAHTA’s (International Network of Agencies for Health Technology Assessment)
HTA database helped to identify assessment reports issued by national or regional HTA
agencies on HBOT. This consultation was completed by a manual search for reports
regarding HBOT on the websites of HTA institutes mentioned on the INAHTA
website. This search was performed independently by two researchers (CO and MN).
The final search was performed on January 3, 2008.
4.2.1.2 Electronic databases
In January 2008, databases were searched to identify all relevant HTA reports,
systematic reviews and full economic evaluations measuring the cost-effectiveness of
HBOT. The following electronic databases were consulted: Medline, Embase, Centre for
Reviews and Dissemination (CRD) databases (Database of Abstracts of Reviews of
Effects (DARE), NHS Economic Evaluation Database (NHS EED), and Health
Technology Assessments (HTA)), Cochrane Database of Systematic Reviews (CDSR),
and Econlit. No restrictions on the time period and language were imposed. An
overview of the search strategy and results are provided in appendix.
4.2.2 Selection criteria
All returned references were assessed based on title, abstract and keywords. When no
abstract was available or the reference was unclear or ambiguous, consideration of the
reference was made on the basis of full-text assessment. Reference lists of retrieved
papers were checked for additional relevant references. This whole literature search
and selection procedure was repeated by a second reviewer to assess the quality of this
process.
Papers fulfilling several selection criteria were included in the economic review. Full
economic evaluations that compare two or more alternatives and consider both costs
and consequences, including cost-effectiveness, cost-utility and cost-benefit analysis,
were eligible. The outcomes should be expressed as costs per life-years gained (LYG),
costs per quality-adjusted life years (QALYs) gained, or any other appropriate diseasespecific
health outcome. The latter refers to e.g. the cost per amputation avoided.
Other types of studies, such as cost descriptions or cost comparisons were not seen as
full economic evaluations (Figure 21).