TY - JOUR
T1 - Investigating the generalizability of Economic Evaluations conducted in Italy: a critical review
AU - Ruggeri, Matteo
AU - Manca, Andrea
AU - Coretti, Silvia
AU - Codella, Paola
AU - Iacopino, Valentina
AU - Romano, Federica
AU - Orlando, Valentina
AU - Mascia, Daniele
AU - Cicchetti, Americo
PY - 2015
Y1 - 2015
N2 - bstract: Aim. To assess the methodological quality of Italian HEEs and their generalizability or
transferability to different settings.
Methods. A literature search was performed on Pubmed search engine to identify trial-based, non-
experimental prospective studies or model-based full economic evaluations, carried out in Italy from
1995 to 2013. The studies were randomly assigned to four reviewers who applied a detailed checklist
to assess the generalizability and the quality of reporting. The review process followed a three-step
blinded procedure. The reviewers who carried out the data extraction were blind as to the name of the
author(s) of each study. Second, after the first review, articles were re-assigned through a second blind
randomization to a second reviewer. Finally, any disagreement between the first two reviews was
solved by a senior researcher.
Results. One-hundred fifty-one economic evaluations eventually met the inclusion criteria. Over time,
we observed an increasing transparency of methods and a greater generalizability of results, along
with a wider and more representative sample in trials and a larger adoption of transition-Markov
models. On the other hand, often context-specific economic evaluations are carried out and not enough
effort is done to assure the transferability of their results to other contexts. In recent studies, Cost-
Effectiveness Analyses and the use of the Incremental Cost-Effectiveness Ratio were preferred.
Conclusion. Despite a quite positive temporal trend, generalizability of results still appears as an
unsolved question, even if some indication of improvement within Italian studies has been observed
AB - bstract: Aim. To assess the methodological quality of Italian HEEs and their generalizability or
transferability to different settings.
Methods. A literature search was performed on Pubmed search engine to identify trial-based, non-
experimental prospective studies or model-based full economic evaluations, carried out in Italy from
1995 to 2013. The studies were randomly assigned to four reviewers who applied a detailed checklist
to assess the generalizability and the quality of reporting. The review process followed a three-step
blinded procedure. The reviewers who carried out the data extraction were blind as to the name of the
author(s) of each study. Second, after the first review, articles were re-assigned through a second blind
randomization to a second reviewer. Finally, any disagreement between the first two reviews was
solved by a senior researcher.
Results. One-hundred fifty-one economic evaluations eventually met the inclusion criteria. Over time,
we observed an increasing transparency of methods and a greater generalizability of results, along
with a wider and more representative sample in trials and a larger adoption of transition-Markov
models. On the other hand, often context-specific economic evaluations are carried out and not enough
effort is done to assure the transferability of their results to other contexts. In recent studies, Cost-
Effectiveness Analyses and the use of the Incremental Cost-Effectiveness Ratio were preferred.
Conclusion. Despite a quite positive temporal trend, generalizability of results still appears as an
unsolved question, even if some indication of improvement within Italian studies has been observed
KW - economic evaluations
KW - generalizability
KW - economic evaluations
KW - generalizability
UR - http://hdl.handle.net/10807/79428
U2 - 10.1016/j.jval.2015.03.1795
DO - 10.1016/j.jval.2015.03.1795
M3 - Article
SN - 1098-3015
VL - 18
SP - 709
EP - 720
JO - Value in Health
JF - Value in Health
ER -