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Appendix 2TABLE 75 Checklist for Patel et al. 105 – The cost-effectiveness of endovascular repair versus open surgical repair of abdominal aorticaneurysms: a decision analysis model (continued)Study question Grade Comments18. The year and country to which unit costs apply arestated with appropriate adjustments for inflation and/orcurrency conversionBenefit measurement and valuation19. The primary outcome measure(s) for the economicevaluation are clearly stated20. Methods to value health states and other benefits arestated21. Details of the individuals from whom valuations wereobtained are given✓✓✓✗Methods to value health states are given althoughthey appear inappropriateDecision modelling22. Details of any decision model used are given (e.g. decision ✓tree, Markov model)23. The choice of model used and the key input parameters ✓on which it is based are adequately detailed and justified24. All model outputs described adequately ✓/✗ Results are presented but, with the exception ofthe base case, costs and QALYs are not reportedseparately and only ICERs are reportedDiscounting25. Discount rate used for both costs and benefits ✓26. Do discount rates accord with NHS guidance? ✗ Discounted at 3% per annum rather than 3.5%Allowance for uncertaintyStochastic analysis of patient-level data27. Details of statistical tests and confidence intervals aregiven for stochastic data28. Uncertainty around cost-effectiveness expressed (e.g.confidence interval around ICER, cost-effectivenessacceptability curves)29. Sensitivity analysis used to assess uncertainty in nonstochasticvariables (e.g. unit costs, discount rates) andanalytic decisions (e.g. methods to handle missing data)Stochastic analysis of decision models30. Are all appropriate input parameters included withuncertainty?31. Is second-order uncertainty (uncertainty in means)included rather than first order (uncertainty betweenpatients)?32. Are the probability distributions adequately detailed andappropriate?33. Sensitivity analysis used to assess uncertainty in nonstochasticvariables (e.g. unit costs, discount rates) andanalytic decisions (e.g. methods to handle missing data)✗✗✓✗✗✗✓172Deterministic analysis34. The approach to sensitivity analysis is given (e.g.univariate, threshold analysis, etc.)? Not stated but both one-way and thresholdsensitivity analyses are undertaken35. The choice of variables for sensitivity analysis is justified ? They tested parameters based on their originalassumptions36. The ranges over which the variables are varied are stated ✗
DOI: 10.3310/hta13480 Health Technology Assessment 2009; Vol. 13: No. 48TABLE 75 Checklist for Patel et al. 105 – The cost-effectiveness of endovascular repair versus open surgical repair of abdominal aorticaneurysms: a decision analysis model (continued)Study question Grade CommentsPresentation of results37. Incremental analysis is reported using appropriate ✓decision rules38. Major outcomes are presented in a disaggregated as well ✗as an aggregated form39. Applicable to the NHS setting ✗ US basedTABLE 76 Checklist for Bosch et al. 108 – Abdominal aortic aneurysms: cost-effectiveness of elective endovascular and open surgicalrepairStudy question Grade Comments1. Costs and effects examined ✓2. Alternatives compared ✓3. The viewpoint(s)/perspective of the analysis is clearly ?stated (e.g. NHS, society)Selection of alternatives4. All relevant alternatives are compared (including donothing if applicable)5. The alternatives being compared are clearly described(who did what, to whom, where and how often)6. The rationale for choosing the alternative programmes orinterventions compared is statedForm of evaluation7. The choice of form of economic evaluation is justified inrelation to the questions addressed8. If a cost-minimisation design is chosen, have equivalentoutcomes been adequately demonstrated?✓/?✓✓✓N/AEffectiveness data9. The source(s) of effectiveness estimates used are stated ✓(e.g. single study, selection of studies, systematic review,expert opinion)10. Effectiveness data from RCT or review of RCTs ✗11. Potential biases identified (especially if data not from ✓RCTs)12. Details of the method of synthesis or meta-analysis of ✓estimates are given (if based on an overview of a numberof effectiveness studies)Costs13. All of the important and relevant resource use included ✓14. All of the important and relevant resource use measured ✗accurately (with methodology)15. Appropriate unit costs estimated (with methodology) ?16. Unit costs reported separately from resource use data ✗continued173© 2009 Queen’s Printer and Controller of HMSO. All rights reserved.
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