The Quality of Economic Evaluations in the Otolaryngology Literature

Abstract

Objectives: (1) Identify factors that may predict the quality of economic evaluations in the otolaryngology literature. (2) Identify current weaknesses in published economic evaluations for the purposes of improving the quality of future studies. Methods: This is a retrospective quality review of published economic evaluations using the validated Quality of Health Economic Studies (QHES) instrument. A systematic review of the Medline, Embase, PubMed, and NHS economic evaluation databases was performed using otolaryngology key terms combined with the terms cost and effectiveness. A manual search of 33 otolaryngology journals was also performed to prevent missed studies. Included studies were graded using the QHES instrument, a 16-item checklist providing a total quality score of 100. Results: Fifty studies were identified, and the mean QHES rating was 54.7 (SD: 31.0). Higher quality economic evaluations were associated with a higher journal impact factor (correlation coefficient r 0.62, P < .01), having an author with a PhD in health economics ( r 0.56, P < .01), and having authors who have published prior economic evaluations ( r 0.46, P < .01). The most commonly omitted methodology was lack of defining the cost perspective and lack of a robust sensitivity analysis. Conclusions: The quality of economic evaluations is important to properly inform efficient allocation of scarce health care resources. Our study investigated the overall quality of economic evaluations in the otolaryngology literature and demonstrated that there is potential to improve the quality of published studies. Future studies should follow published methodology guidelines and consider collaborating with authors who have experience with economic evaluation.