Most guideline organizations lack explicit guidance in how to incorporate cost considerations
Por:
Sanabria, AJ, Kotzeva, A, Olid, AS, Pequeno, S, Vernooij, RWM, Garcia, LM, Zhang, Y, Sola, I, Thornton, J, Alonso-Coello, P
Publicada:
1 dic 2019
Resumen:
Objectives: Resource use and cost (RUC) evidence is one of the factors that can be considered when formulating recommendations in clinical practice guidelines (CPGs). However, it is unclear how CPG developers incorporate this information. The purpose of this study was to identify available guidance from guideline organizations on how to incorporate RUC in CPGs.
Study Design and Setting: This is a methodological survey. We searched MEDLINE, the G-I-N library, the Cochrane Methodology Register, and gray literature from inception to 2017. We included the most recent version of guidance documents. We excluded those that only reported methodology for adapting, endorsing, or updating CPGs, and documents reporting methods followed in the development of one or more specific CPGs.
Results: We included 77 documents from 67 organizations. Fifty-nine organizations (88.1%) include information regarding RUC during the CPG development process. Fifty-five (82.1%) organizations report taking RUC into account when developing recommendations: 44 (65.7%) do this explicitly, 5 (7.5%) implicitly, and 6 (9.0%) explicitly as optional. Twelve of the 44 organizations that explicitly consider RUC (27.3%) provide guidance to identify, assess and use the RUC evidence when developing recommendations. Twenty-three consider RUC when moving from the evidence to recommendations (52.3%). Seventeen of the 44 (38.6%) recommend making qualitative judgments about whether the desirable effects of interventions were worth the associated costs.
Conclusion: More explicit guidance is needed alongside tools to help CPGs developers incorporate RUC evidence when formulating recommendations. Our results may be of use for guideline developers to improve this guidance. (C) 2019 Elsevier Inc. All rights reserved.
Filiaciones:
Sanabria, AJ:
Biomed Res Inst St Pau JIB St Pau, Iberoamer Cochrane Ctr, St Antoni Maria Claret 167, Barcelona 08025, Catalonia, Spain
Kotzeva, A:
F Hoffmann La Roche Ltd, Basel, Switzerland
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Olid, AS:
Biomed Res Inst St Pau JIB St Pau, Iberoamer Cochrane Ctr, St Antoni Maria Claret 167, Barcelona 08025, Catalonia, Spain
Corp Sanithria Parc Tauli, Clin Epidemiol & Canc Screening Dept, Pare Tauli 1, Sabadell 08208, Spain
Res Network Hlth Serv Chron Dis REDISSEC, Barcelona, Spain
Pequeno, S:
Biomed Res Inst St Pau JIB St Pau, Iberoamer Cochrane Ctr, St Antoni Maria Claret 167, Barcelona 08025, Catalonia, Spain
Vernooij, RWM:
Biomed Res Inst St Pau JIB St Pau, Iberoamer Cochrane Ctr, St Antoni Maria Claret 167, Barcelona 08025, Catalonia, Spain
Garcia, LM:
Biomed Res Inst St Pau JIB St Pau, Iberoamer Cochrane Ctr, St Antoni Maria Claret 167, Barcelona 08025, Catalonia, Spain
Zhang, Y:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
Sola, I:
Biomed Res Inst St Pau JIB St Pau, Iberoamer Cochrane Ctr, St Antoni Maria Claret 167, Barcelona 08025, Catalonia, Spain
Thornton, J:
Natl Inst Hlth & Care Excellence, Manchester, Lancs, England
Alonso-Coello, P:
Biomed Res Inst St Pau JIB St Pau, Iberoamer Cochrane Ctr, St Antoni Maria Claret 167, Barcelona 08025, Catalonia, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
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