How methodologic differences affect results of economic analyses: a systematic review of interferon gamma release assays for the diagnosis of LTBI.

<h4>Introduction</h4>Cost effectiveness analyses (CEA) can provide useful information on how to invest limited funds, however they are less useful if different analysis of the same intervention provide unclear or contradictory results. The objective of our study was to conduct a systemat...

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Main Authors: Olivia Oxlade, Marcia Pinto, Anete Trajman, Dick Menzies
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0056044
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author Olivia Oxlade
Marcia Pinto
Anete Trajman
Dick Menzies
author_facet Olivia Oxlade
Marcia Pinto
Anete Trajman
Dick Menzies
author_sort Olivia Oxlade
collection DOAJ
description <h4>Introduction</h4>Cost effectiveness analyses (CEA) can provide useful information on how to invest limited funds, however they are less useful if different analysis of the same intervention provide unclear or contradictory results. The objective of our study was to conduct a systematic review of methodologic aspects of CEA that evaluate Interferon Gamma Release Assays (IGRA) for the detection of Latent Tuberculosis Infection (LTBI), in order to understand how differences affect study results.<h4>Methods</h4>A systematic review of studies was conducted with particular focus on study quality and the variability in inputs used in models used to assess cost-effectiveness. A common decision analysis model of the IGRA versus Tuberculin Skin Test (TST) screening strategy was developed and used to quantify the impact on predicted results of observed differences of model inputs taken from the studies identified.<h4>Results</h4>Thirteen studies were ultimately included in the review. Several specific methodologic issues were identified across studies, including how study inputs were selected, inconsistencies in the costing approach, the utility of the QALY (Quality Adjusted Life Year) as the effectiveness outcome, and how authors choose to present and interpret study results. When the IGRA versus TST test strategies were compared using our common decision analysis model predicted effectiveness largely overlapped.<h4>Implications</h4>Many methodologic issues that contribute to inconsistent results and reduced study quality were identified in studies that assessed the cost-effectiveness of the IGRA test. More specific and relevant guidelines are needed in order to help authors standardize modelling approaches, inputs, assumptions and how results are presented and interpreted.
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spelling doaj-art-a504db3a68dc43cf9882a66ed255fda92025-08-20T03:29:10ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0183e5604410.1371/journal.pone.0056044How methodologic differences affect results of economic analyses: a systematic review of interferon gamma release assays for the diagnosis of LTBI.Olivia OxladeMarcia PintoAnete TrajmanDick Menzies<h4>Introduction</h4>Cost effectiveness analyses (CEA) can provide useful information on how to invest limited funds, however they are less useful if different analysis of the same intervention provide unclear or contradictory results. The objective of our study was to conduct a systematic review of methodologic aspects of CEA that evaluate Interferon Gamma Release Assays (IGRA) for the detection of Latent Tuberculosis Infection (LTBI), in order to understand how differences affect study results.<h4>Methods</h4>A systematic review of studies was conducted with particular focus on study quality and the variability in inputs used in models used to assess cost-effectiveness. A common decision analysis model of the IGRA versus Tuberculin Skin Test (TST) screening strategy was developed and used to quantify the impact on predicted results of observed differences of model inputs taken from the studies identified.<h4>Results</h4>Thirteen studies were ultimately included in the review. Several specific methodologic issues were identified across studies, including how study inputs were selected, inconsistencies in the costing approach, the utility of the QALY (Quality Adjusted Life Year) as the effectiveness outcome, and how authors choose to present and interpret study results. When the IGRA versus TST test strategies were compared using our common decision analysis model predicted effectiveness largely overlapped.<h4>Implications</h4>Many methodologic issues that contribute to inconsistent results and reduced study quality were identified in studies that assessed the cost-effectiveness of the IGRA test. More specific and relevant guidelines are needed in order to help authors standardize modelling approaches, inputs, assumptions and how results are presented and interpreted.https://doi.org/10.1371/journal.pone.0056044
spellingShingle Olivia Oxlade
Marcia Pinto
Anete Trajman
Dick Menzies
How methodologic differences affect results of economic analyses: a systematic review of interferon gamma release assays for the diagnosis of LTBI.
PLoS ONE
title How methodologic differences affect results of economic analyses: a systematic review of interferon gamma release assays for the diagnosis of LTBI.
title_full How methodologic differences affect results of economic analyses: a systematic review of interferon gamma release assays for the diagnosis of LTBI.
title_fullStr How methodologic differences affect results of economic analyses: a systematic review of interferon gamma release assays for the diagnosis of LTBI.
title_full_unstemmed How methodologic differences affect results of economic analyses: a systematic review of interferon gamma release assays for the diagnosis of LTBI.
title_short How methodologic differences affect results of economic analyses: a systematic review of interferon gamma release assays for the diagnosis of LTBI.
title_sort how methodologic differences affect results of economic analyses a systematic review of interferon gamma release assays for the diagnosis of ltbi
url https://doi.org/10.1371/journal.pone.0056044
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