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Most guideline organizations lack explicit guidance in how to incorporate cost considerations

Most guideline organizations lack explicit guidance in how to incorporate cost considerations

Authors :
Laura Martínez García
Ivan Solà
Judith Thornton
Andrea Juliana Sanabria
Anna Selva Olid
Yuan Zhang
Robin W.M. Vernooij
Pablo Alonso-Coello
Anna Kotzeva
Sandra Pequeño
Source :
Journal of Clinical Epidemiology. 116:72-83
Publication Year :
2019
Publisher :
Elsevier BV, 2019.

Abstract

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.

Details

ISSN :
08954356
Volume :
116
Database :
OpenAIRE
Journal :
Journal of Clinical Epidemiology
Accession number :
edsair.doi.dedup.....718f84db335dc67e7d6fa2d93155c7b0
Full Text :
https://doi.org/10.1016/j.jclinepi.2019.08.004