Xie, Feng;
Shemilt, Ian;
Vale, Luke;
Ruiz, Francis;
Drummond, Michael F;
Lord, Joanne;
Herrmann, Kirsten H;
... GRADE Working Group; + view all
(2023)
GRADE guidance 23: Considering cost-effectiveness evidence in moving from evidence to health-related recommendations.
Journal of Clinical Epidemiology
10.1016/j.jclinepi.2023.08.001.
(In press).
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Abstract
BACKGROUND: This is the 23rd in a series of articles describing the GRADE approach to grading the certainty of evidence and strength of recommendations for systematic reviews, health technology assessments, and clinical guideline development. OBJECTIVES: We outline how resource utilization and cost-effectiveness analyses (CEAs) are integrated into health-related recommendations, using the GRADE Evidence-to-Decision (EtD) framework. METHODS: Through iterative discussions and refinement, in-person, and online meetings, and through email communication, we developed draft guidance to incorporating economic evidence in the formulation of health-related recommendations. We developed scenarios to operationalize the guidance. We presented a summary of the results to members of the GRADE Economic Evaluation Project Group. RESULTS: We describe how to estimate the cost of preventing (or achieving) an event to inform assessments of cost-effectiveness of alternative treatments, when there are no published economic evaluations. Evidence profiles and Summary of Findings (SoF) tables based on systematic reviews of CEAs can be created to provide top-level summaries of results and quality of multiple published economic evaluations. We also describe how this information could be integrated in GRADE's EtD frameworks to inform health-related recommendations. Three scenarios representing various levels of available cost-effectiveness evidence were used to illustrate the integration process. CONCLUSIONS: This GRADE guidance provides practical information for presenting cost-effectiveness data, and its integration in the development of health-related recommendations, using the EtD framework.
| Type: | Article |
|---|---|
| Title: | GRADE guidance 23: Considering cost-effectiveness evidence in moving from evidence to health-related recommendations |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jclinepi.2023.08.001 |
| Publisher version: | https://doi.org/10.1016/j.jclinepi.2023.08.001 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Cost effectiveness analysis, GRADE, Guidelines, Systematic reviews |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10175815 |
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