A systematic review of health economic evaluations of proton beam therapy for adult cancer: Appraising methodology and quality.

Autor:	Jones DA; Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, UK., Smith J; Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, UK.; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK., Mei XW; Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, UK., Hawkins MA; CRUK/MRC Oxford Institute for Radiation Oncology, Oxford, UK., Maughan T; CRUK/MRC Oxford Institute for Radiation Oncology, Oxford, UK., van den Heuvel F; CRUK/MRC Oxford Institute for Radiation Oncology, Oxford, UK.; Department of Haematology/Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Mee T; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK., Kirkby K; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK., Kirkby N; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK., Gray A; Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, UK.; NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.
Jazyk:	angličtina
Zdroj:	Clinical and translational radiation oncology [Clin Transl Radiat Oncol] 2019 Oct 31; Vol. 20, pp. 19-26. Date of Electronic Publication: 2019 Oct 31 (Print Publication: 2020).
DOI:	10.1016/j.ctro.2019.10.007
Abstrakt:	Background and Purpose: With high treatment costs and limited capacity, decisions on which adult patients to treat with proton beam therapy (PBT) must be based on the relative value compared to the current standard of care. Cost-utility analyses (CUAs) are the gold-standard method for doing this. We aimed to appraise the methodology and quality of CUAs in this area. Materials and Methods: We performed a systematic review of the literature to identify CUA studies of PBT in adult disease using MEDLINE, EMBASE, EconLIT, NHS Economic Evaluation Database (NHS EED), Web of Science, and the Tufts Medical Center Cost-Effectiveness Analysis Registry from 1st January 2010 up to 6th June 2018. General characteristics, information relating to modelling approaches, and methodological quality were extracted and synthesized narratively. Results: Seven PBT CUA studies in adult disease were identified. Without randomised controlled trials to inform the comparative effectiveness of PBT, studies used either results from one-armed studies, or dose-response models derived from radiobiological and epidemiological studies of PBT. Costing methods varied widely. The assessment of model quality highlighted a lack of transparency in the identification of model parameters, and absence of external validation of model outcomes. Furthermore, appropriate assessment of uncertainty was often deficient. Conclusion: In order to foster credibility, future CUA studies must be more systematic in their approach to evidence synthesis and expansive in their consideration of uncertainties in light of the lack of clinical evidence. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper (Crown Copyright © 2019 Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu