Abstract
Background: New emerging evidence has demonstrated the need for effective interventions to help people living with an acquired brain injury (ABI). Evidence on cost-effectiveness, which can help inform use of limited resources, is scarce in this area and therefore the purpose of this systematic review is to critically appraise and consolidate the current evidence on economic evaluations of ABI rehabilitation interventions. Methods: Systematic review methodology will be applied to identify, select and extract data from published economic evaluation studies (trial-based, non-trial based, simulation-based, decision model and trial-based model economic evaluations) of ABI treatment interventions in adults. A systematic literature search will be conducted on the following electronic databases: EMBASE, Econlit, CINAHL, Medline, Econlit, the National Health Service Economic Evaluation Database and PsyclNFO. This review will only include cost-effectiveness analysis studies (e.g., cost per life year gained), cost-benefit and cost minimisation analyses in which the designs were randomised controlled trials (RCTs), non-RCT studies, cost-utility analyses (e.g., cost per quality-adjusted life year (QALY) gained or cost per disability-adjusted life year averted), cohort studies, and modeling studies. Only studies that were published in English, associated with adults who have an ABI will be included. There will be no restrictions on perspective, sample size, country, follow-up duration or setting. The search strategy terms will include the following: acquired brain injury, brain*; cost*; or cost-benefit analysis*. Following data extraction, a narrative summary and tables will be used to summarize the characteristics and results of included studies. Discussion: The findings from this review will be beneficial to health policy decision makers when examining the evidence of economic evaluations in this field. In addition, it is anticipated that this review will identify gaps in the current economic literature to inform future-related research. Systematic review registration: PROSPERO CRD42020187469 (25 th June 2020).
Highlights
Acquired brain injury (ABI) is an injury to the brain that is not hereditary, degenerative, congenital, or brought about by birth trauma; it happens after birth[1]
Whilst no official costs of acquired brain injury (ABI) exists in Europe, the costs of traumatic brain injury (TBI) are projected to be €33 billion[7], it is estimated that stroke care treatment are around €27 billion, with around €18.5 billion contributing towards the direct medical costs and around €8.5 billion for indirect costs[8]
The vast number of non-pharmacological interventions for patients with ABI disorders and their caregivers have risen in recent years[12,13] and many have been shown to be effective in reducing behavioral and psychological symptoms associated with having an ABI
Summary
Acquired brain injury (ABI) is an injury to the brain that is not hereditary, degenerative, congenital, or brought about by birth trauma; it happens after birth[1]. In Ireland, there does not currently exist an adequate system for registering the prevalence and incidence and of ABI on an international and national basis, but informal estimates from the Irish National Audit of Stroke Care and data from the Hospital In-Patient Enquiry scheme indicates that each year in the country around 20,000 brain injuries occur[3]. Evidence on cost-effectiveness, which can help inform use of limited resources, is scarce in this area and the purpose of this systematic review is to critically appraise and consolidate the current evidence on economic evaluations of ABI rehabilitation interventions. Methods: Systematic review methodology will be applied to identify, select and extract data from published economic evaluation studies (trial-based, non-trial based, simulation-based, decision model and trial-based model economic evaluations) of ABI treatment interventions in adults. A narrative summary and tables will be used to summarize version 2 (revision)
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