Economics methods in Cochrane systematic reviews of health promotion and public health related interventions

Ian Shemilt^*¹ , Miranda Mugford^*¹ , Michael Drummond² , Eric Eisenstein³ , Jacqueline Mallender⁴ , David McDaid⁵ , Luke Vale⁶ , Damian Walker⁷ and The Campbell & Cochrane Economics Methods Group (CCEMG)²^,3^,4^,5^,6^,7

¹School of Medicine, Health Policy & Practice, University of East Anglia, Norwich, UK

²Centre for Health Economics, University of York, UK

³Duke University Medical Center, North Carolina, USA

⁴Matrix Research & Consultancy Ltd, London, UK

⁵LSE Health and Social Care, London School of Economics, UK

⁶Health Economics Research Unit, University of Aberdeen, UK

⁷John Hopkins Bloomberg School of Public Health, Baltimore, USA

author email corresponding author email* Contributed equally

BMC Medical Research Methodology 2006, 6:55doi:10.1186/1471-2288-6-55


Published:	15 November 2006

Abstract

Background

Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Reviews of evidence on the effects of interventions are published by both the Cochrane and Campbell Collaborations. Although it is not a requirement that Cochrane or Campbell Reviews should consider economic aspects of interventions, many do. This study aims to explore and describe approaches to incorporating economics methods in a selection of Cochrane systematic reviews in the area of health promotion and public health, to help inform development of methodological guidance on economics for reviewers.

Methods

The Cochrane Database of Systematic Reviews was searched using a search strategy for potential economic evaluation studies. We included current Cochrane reviews and review protocols retrieved using the search that are also identified as relevant to health promotion or public health topics. A reviewer extracted data which describe the economics components of included reviews. Extracted data were summarised in tables and analysed qualitatively.

Results

Twenty-one completed Cochrane reviews and seven review protocols met inclusion criteria. None incorporate formal economic evaluation methods. Ten completed reviews explicitly aim to incorporate economics studies and data. There is a lack of transparent reporting of methods underpinning the incorporation of economics studies and data. Some reviews are likely to exclude useful economics studies and data due to a failure to incorporate search strategies tailored to the retrieval of such data or use of key specialist databases, and application of inclusion criteria designed for effectiveness studies.

Conclusion

There is a need for consistency and transparency in the reporting and conduct of the economics components of Cochrane reviews, as well as regular dialogue between Cochrane reviewers and economists to develop increased capacity for economic analyses alongside such reviews. Use of applicable economics methods in Cochrane reviews can help provide the international context within which economics data can be interpreted and assessed as a preliminary to full economic evaluation.