The role of health economic evidence in clinical practice guidelines for colorectal cancer: a comparative analysis across countries
Aim: Colorectal cancer (CRC) is among the most prevalent malignancies globally and causes massive resource consumption and economic burden. Health economic evidence (HEE) has been used in clinical practice guidelines (CPGs) for cancer to facilitate the rational allocation of health resources. Howe...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Becaris Publishing Limited
2025-02-01
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| Series: | Journal of Comparative Effectiveness Research |
| Subjects: | |
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| Summary: | Aim: Colorectal cancer (CRC) is among the most prevalent malignancies globally and causes massive
resource consumption and economic burden. Health economic evidence (HEE) has been used in clinical
practice guidelines (CPGs) for cancer to facilitate the rational allocation of health resources. However,
in certain guideline development organizations, HEE is not yet utilized as a formal decision-making
criterion. This study aimed to compare the discrepancies in the utilization of health economics as evidence
in CRC CPGs across different countries and review specific features of economic evidence concerning
the guidelines’ applicability. Materials & methods: A systematic review was conducted using databases
including Medline, Embase, CNKI, WanFang, and other guidelines databases to identify CPGs for CRC
published in English or Chinese from January 2017 to September 2023. Data on the incorporation and
application of HEE were extracted, and themethod and quality of cost–effectiveness analysis (CEA) studies
were evaluated. Descriptive analyses were used to summarize the results. Results: Out of 53 CPGs from
14 countries, most originated from the USA (n = 17 of 53 [32%]) and Canada (n = 9 of 53 [17%]). Sixtyeight
percent (36/53) considered cost justification, and 57% (30/53) incorporated health economics studies
as evidence. The included HEE cited in CPGs ranged from 1990 to 2021 and were not aligned with the
countries in which the guidelines were issued. Among these CEA studies, 52% (26/50) were related to
screening strategies, and 32% (16/50) pertained to treatment measures. The Markov model was the most
frequently used (n = 27 of 50 [54%]). Based on the CHEQUE tool, the methodological quality of these CEA
studies was inadequate in areas such as multiple data sources, approaches to select data sources, assessing
the quality of data, and relevant equity or distribution. Conclusion: In summary, 57% of guidelines
incorporated health economics studies as evidence, with a variation between different countries. The
included HEE still had deficiencies in methodology and reporting quality. In the future, it is suggested
that health economics research should use a standardized methodology and reporting approach to assist
in clinical decision making. |
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| ISSN: | 2042-6313 |