Critical appraisal of included economic papers using Drummond et al's32 checklist
| Study | Well-defined question posed in answerable form | Comprehensive description of the competing alternatives given | Effectiveness of the programme or service established | All important and relevant costs and consequences for each alternative identified | Costs and consequences measured accurately in appropriate physical units | Cost and consequences valued credibly | Costs and consequences adjusted for differential timing | Incremental analysis of costs and consequences of alternatives performed | Allowance made for uncertainty in the estimates of cost and consequences | Presentation and discussion of study results included all issues of concerns to users |
|---|---|---|---|---|---|---|---|---|---|---|
| Anokye et al35 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes, probabilistic sensitivity analysis | Yes |
| Boehler et al36 | Yes | Yes | Yes | Yes | Yes | Yes | Not relevant | Yes | Yes, probabilistic sensitivity analysis | Yes |
| Cobiac et al44 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes, probabilistic sensitivity analysis | Yes |
| Dalziel et al40 | Yes | Yes | Yes | Only included programme costs—cost of downstream events not included eg, CVD, diabetes | Yes | Not all sources cited (eg, source for overhead costs) | Yes | Yes | Yes, probabilistic sensitivity analysis | Yes |
| Elley et al42 | Yes | Yes | Yes | Yes | Yes | Not all sources cited (eg, source for overhead costs) | Yes | Yes but excluded lost productivity from calculation (reason given by authors) | Yes, one way sensitivity analysis | Yes |
| Elley et al41 | Yes | Yes | Yes | Yes | Yes | Yes | Mostly; second year costs not discounted | Yes | Yes, one way sensitivity analysis and hypothesis test but of geometric means | Yes |
| Gulliford et al37 | Yes | Insufficient detail | Yes | Yes | Yes | Insufficient detail | Yes | Yes | Yes, probabilistic sensitivity analysis | Yes |
| Leung et al43 | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes, probabilistic sensitivity analysis | Yes |
| Lindgren et al46 | Yes | Yes but hypothetical intervention | Yes | Yes | Yes | Authors state time and travel costs not included | Yes | Yes | Probabilistic sensitivity analysis and scenario analysis | Yes |
| Over et al47 | Yes | Yes | Yes | Insufficient detail | Insufficient detail | Not all sources cited (cost, utility) | Yes | Yes | Yes, probabilistic sensitive analysis | Yes |
| Pringle et al38 | Yes | Unclear if usual practice and all the relevant comparators included, although full details provided in referenced sources | Insufficient detail about source of study | Out-of-pocket expenditure excluded | Yes | Yes | Yes | Yes | Yes, one way sensitivity analysis | Minimal information about economic model and sensitivity analysis, although references to more details are provided |
| Shaw et al39 | Yes | Yes | Yes | Restricted to intervention costs | Yes | Sources cited but not clear which relates to which unit cost | Not applicable to within-trial analysis, threshold analysis for £/QALY does not appear to take discounting into account | Yes | Mentioned but not described in detail | Discussion limited by broad scope of the paper (qualitative and economic analysis in one paper) |
| Sims et al45 | Yes | Yes | Yes | Yes | Yes | Not all sources cited | Not clearly mentioned | Yes | Yes, univariate sensitivity analysis | Yes but not in detail |
CVD, cardiovascular disease; QALY, quality-adjusted life year.