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Reading and Interpreting Economic Evaluations in Rheumatoid Arthritis: An Assessment of Selected Instruments for Critical Appraisal
MICHAEL H. WEISMAN, ANACLETO D. GANO Jr, SHERINE E. GABRIEL, MARC C. HOCHBERG, ARTHUR KAVANAUGH, MATTHEW H. LIANG, JOSHUA J. OFMAN, MARK PRASHKER, MARIA E. SUAREZ-ALMAZOR, EDWARD YELIN, SHOSHANNA D. NAKELSKY, and JOSEPH D. CROFT Jr, on behalf of the Evidence-Based Medicine Working Groups in Rheumatology
ABSTRACT.
Methods. An expert panel, comprising rheumatology researchers and clinicians, operationalized 2 economic appraisal instruments and applied them to 11 articles used for analysis. Each expert reviewed 3 articles, with each article independently reviewed by a pair of experts. A summary score for each article per appraisal instrument was calculated by dividing the number of items that received a "positive" response by the total number of items in the appraisal instrument. Results. Scores for each article were similar across reviewers and appraisal instruments. Conclusion. There is a need for a more comprehensive approach for evaluating this rapidly growing body of economic literature that is not only valid and reliable, but also easy to apply and understand. Although consistency between reviewers was good on both guidelines, inter-guideline discrepancies were noted and reviewers reported some difficulty in using the operationalized format. (J Rheumatol 2003;30:1739-47) Key Indexing Terms:
ECONOMICS From the Evidence-Based Medicine Working Groups in Rheumatology and Zynx Health Incorporated, Beverly Hills, CA, USA. Supported by an unrestricted educational grant by Amgen, Inc., Thousand Oaks, CA, USA. J.D. Croft Jr, MD, Clinical Professor of Medicine (Rheumatology) Georgetown University Medical School, Washington, DC; S.E. Gabriel, MD, MSc, Chair, Department of Health Sciences Research, Professor of Medicine and Epidemiology, Health Sciences Research and Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN; A.D. Gano Jr, MPH, Research Associate, Zynx Health Inc., Beverly Hills, CA; S.D. Nakelsky, MPH, Research Associate; J.J. Ofman, MD, MSHS, Assistant Professor, Departments of Medicine and Health Services Research, UCLA School of Medicine, Los Angeles, CA, Senior Vice President of Research, Zynx Health Inc., Beverly Hills, CA; M.C. Hochberg, MD, MPH, Professor of Medicine, Department of Medicine, University of Maryland School of Medicine, Head, Division of Rheumatology and Clinical Immunology, Department of Medicine, Maryland Veterans Affairs Health Care System, Baltimore, MD; A. Kavanaugh, MD, The Center for Innovative Therapy, Division of Rheumatology, Allergy and Immunology, University of California, San Diego, CA; M.H. Liang, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Professor, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA; M. Prashker, MD, MPH, Director, Center for Health Quality, Outcomes and Economic Research, Bedford VA Medical Center, Chair, Health Services Department, Boston University School of Public Health, Boston, MA; M.E. Suarez-Almazor, MD, MSc, PhD, Associate Professor of Medicine, Health Services Research, Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX; M.H. Weisman, MD, Director, Division of Rheumatology, Department of Medicine/Rheumatology, Cedars-Sinai Health Systems, Los Angeles, CA; E. Yelin, PhD, Professor of Medicine and Health Policy, Department of Medicine and Rosalind Russell Medical Research Center for Arthritis, University of California, San Francisco, CA. The Evidence-Based Medicine (EBM) Working Groups in Rheumatology comprises subgroups in Disease Management, Health Economics, and Outcomes Assessment Instruments: Chair, J.D. Croft Jr, MD. Health Economics Working Group: M.H. Weisman, MD; S.D. Nakelsky, MPH, A.D. Gano Jr, MPH; S.E. Gabriel, MD, MSc; M.C. Hochberg, MD, MPH; A. Kavanaugh, MD; M.H. Liang, MD, MPH; M. Prashker, MD, MPH; J.J. Ofman, MD, MSHS; M.E. Suarez-Almazor, MD, MSc, PhD; E. Yelin, PhD. Address reprint requests to Dr. J.J. Ofman, Zynx Health Inc., 9100 Wilshire Blvd., East Tower, Suite 655, Beverly Hills, CA 90212. E-mail: jofman@cerner.com Submitted December 27, 2001; revision accepted January 16, 2003. |