Table 4 Quality of Health Economic Studies scores
CriteriaBeard et al35Campbell et al30Rizzo et al34Robertson et al32Robertson et al31Robertson et al33Sach et al38Salkeld et al36Smith and Widiatmoko37
Percentage (sum/total score)59 (58/99)100 (99/99)75 (74/99)100 (99/99)100 (99/99)92 (91/99)92 (91/99)73 (69/99)47 (47/99)
  • Sixteen criteria of the Quality of Health Economic Studies (QHES) instrument: 1. Was the study objective presented in a clear, specific, and measurable manner? (7 points); 2. Were the perspective of the analysis (societal, third party payer, etc.) and reasons for its selection stated? (4 points); 3. Were variable estimates used in the analysis from the best available source (ie, randomised controlled trial—best, expert opinion—worst)? (8 points); 4. If estimates came from a subgroup analysis, were the groups prespecified at the beginning of the study? (1 point); 5. Was uncertainty handled by: (1) statistical analysis to address random events; (2) sensitivity analysis to cover a range of assumptions? (9 points); 6. Was incremental analysis performed between alternatives for resources and costs? (6 points); 7. Was the methodology for data abstraction (including the value of health states and other benefits) stated? (5 points); 8. Did the analytical horizon allow time for all relevant and important outcomes? Were benefits and costs that went beyond 1 year discounted (3%–5%) and justification given for the discount rate? (7 points); 9. Was the measurement of costs appropriate and the methodology for the estimation of quantities and unit costs clearly described? (8 points); 10. Were the primary outcome measure(s) for the economic evaluation clearly stated, and were the major short-term, long-term and negative outcomes included? (6 points); 11. Were the health outcomes measures/scales valid and reliable? If previously tested valid and reliable measures were not available, was justification given for the measures/scales used? (7 points); 12. Were the economic model (including structure), study methods and analysis, and the components of the numerator and denominator displayed in a clear, transparent manner? (8 points); 13. Were the choice of economic model, main assumptions and limitations of the study stated and justified? (7 points); 14. Did the author(s) explicitly discuss the direction and magnitude of potential biases? (6 points); 15. Were the conclusions/recommendations of the study justified and based on the study results? (8 points); 16. Was there a statement disclosing the source of funding for the study? (3 points).

  • * Study met the criterion.

  • All or part of the criterion was not met.