Table 8, Strengths and Limitations of Economic Studies using the Drummond Checklist - Deep Brain Stimulation for Parkinson’s Disease: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Strengths	Limitations
Dams, 2016²⁶
The research question, its economic importance, the viewpoint of the analysis, and the rationale for choosing the interventions stated The form of economic evaluation is stated and justified in relation to the question addressed The sources of effectiveness estimated are stated The primary outcome measure for the economic evaluation is stated Sources and methods used for estimating costs are stated The currency used for all costs (i.e., 2013, euros) was stated Details of the models are given and the key parameters are justified The time horizon is stated Both costs and health effects were half-cycle corrected and discounted with 3% per annum to adjust for future values Details of statistical methods and approaches to sensitivity analyses are provided The choice of variables for sensitivity analysis is justified; ranges for sensitivity analysis are provided Incremental analysis reported Provided a comparison of base-case findings from this report to other cost studies of DBS for Parkinson’s The conclusions follow from the data reported and are clearly stated with appropriate limitations identified	The alternatives being compared (i.e., BMT) are not clearly described; the report references the RCT³⁵ where these details may be found. It is uncertain if these findings can be applied to the local population (i.e., Canada)
Fundament, 2016²⁸
The research question, its economic importance, the viewpoint of the analysis, and the rationale for choosing the interventions stated The form of economic evaluation is stated and justified in relation to the question addressed The sources of effectiveness estimated are described The primary outcome measure for the economic evaluation is clearly stated Sources and methods used for estimating costs are stated The currency used for all costs (Great British Pounds) was stated Details of the models are given and the key parameters are justified The time horizon is stated Costs and QALYs were both discounted at 3.5% per year, according to NICE methods guidance Details of statistical methods and approaches to sensitivity analyses are provided The choice of variables for sensitivity analysis is justified; ranges for sensitivity analysis are provided Incremental analysis is reported The conclusions follow from the data reported and are clearly stated with appropriate limitations identified	The alternatives being compared (i.e., BMT) are not clearly described; the report references the RCT³⁵ where these details may be found. It is uncertain if these findings can be applied to the local population (i.e., Canada)
Hacker, 2016²⁹
The research question, its economic importance, and the rationale for choosing the interventions stated The form of economic evaluation is stated and justified in relation to the question addressed The sources of effectiveness estimated are described The primary outcome measure for the analysis is stated Sources and methods used for estimating costs are stated The time horizon is stated The conclusions follow from the data reported and limitations are identified	The viewpoint of the analysis not explicitly described Report references 4 other studies that provides information about study design, enrollment experience, baseline characteristics, and outcomes;²³^,³¹^,³⁴^,³⁶ not described in detail in this report. Thus, alternatives being compared (i.e., optimal drug therapy) are not clearly described in report The currency of costs not explicitly stated (implied US dollars, implied medications costs are based on those medications available between 2006 and 2012) Lacking basic details of models, parameters, and statistical methods described No mention of incremental analysis It is uncertain if these findings can be applied to the local population (i.e., Canada)
McIntosh, 2016²⁷
The research question, the viewpoint of the analysis, and the rationale for choosing the interventions stated The form of economic evaluation is stated and justified in relation to the question addressed The sources of effectiveness estimated are described The primary outcome measure for the economic evaluation is clearly stated Sources and methods used for estimating costs are stated The currency used for all costs (i.e., 2010 Great British Pounds) was stated Details of the models are given and the key parameters are justified The time horizon is stated Discount rate for annuitization of capital items was 3.5% (HM Treasury) Details of statistical methods and approaches to sensitivity analyses are provided The choice of variables for sensitivity analysis is justified; ranges for sensitivity analysis are provided Incremental analysis is reported The conclusions follow from the data reported and are clearly stated	The economic importance not described in introduction The alternatives being compared (i.e., BMT) are not clearly described It is uncertain if these findings can be applied to the local population (i.e., Canada) Limitations of the report not described

Strengths

Limitations

Dams, 2016²⁶

The research question, its economic importance, the viewpoint of the analysis, and the rationale for choosing the interventions stated
The form of economic evaluation is stated and justified in relation to the question addressed
The sources of effectiveness estimated are stated
The primary outcome measure for the economic evaluation is stated
Sources and methods used for estimating costs are stated
The currency used for all costs (i.e., 2013, euros) was stated
Details of the models are given and the key parameters are justified
The time horizon is stated
Both costs and health effects were half-cycle corrected and discounted with 3% per annum to adjust for future values
Details of statistical methods and approaches to sensitivity analyses are provided
The choice of variables for sensitivity analysis is justified; ranges for sensitivity analysis are provided
Incremental analysis reported
Provided a comparison of base-case findings from this report to other cost studies of DBS for Parkinson’s
The conclusions follow from the data reported and are clearly stated with appropriate limitations identified

The alternatives being compared (i.e., BMT) are not clearly described; the report references the RCT³⁵ where these details may be found.
It is uncertain if these findings can be applied to the local population (i.e., Canada)

Fundament, 2016²⁸

The research question, its economic importance, the viewpoint of the analysis, and the rationale for choosing the interventions stated
The form of economic evaluation is stated and justified in relation to the question addressed
The sources of effectiveness estimated are described
The primary outcome measure for the economic evaluation is clearly stated
Sources and methods used for estimating costs are stated
The currency used for all costs (Great British Pounds) was stated
Details of the models are given and the key parameters are justified
The time horizon is stated
Costs and QALYs were both discounted at 3.5% per
year, according to NICE methods guidance
Details of statistical methods and approaches to sensitivity analyses are provided
The choice of variables for sensitivity analysis is justified; ranges for sensitivity analysis are provided
Incremental analysis is reported
The conclusions follow from the data reported and are clearly stated with appropriate limitations identified

The alternatives being compared (i.e., BMT) are not clearly described; the report references the RCT³⁵ where these details may be found.
It is uncertain if these findings can be applied to the local population (i.e., Canada)

Hacker, 2016²⁹

The research question, its economic importance, and the rationale for choosing the interventions stated
The form of economic evaluation is stated and justified in relation to the question addressed
The sources of effectiveness estimated are described
The primary outcome measure for the analysis is stated
Sources and methods used for estimating costs are stated
The time horizon is stated
The conclusions follow from the data reported and limitations are identified

The viewpoint of the analysis not explicitly described
Report references 4 other studies that provides information about study design, enrollment experience, baseline characteristics, and outcomes;²³^,³¹^,³⁴^,³⁶ not described in detail in this report. Thus, alternatives being compared (i.e., optimal drug therapy) are not clearly described in report
The currency of costs not explicitly stated (implied US dollars, implied medications costs are based on those medications available between 2006 and 2012)
Lacking basic details of models, parameters, and statistical methods described
No mention of incremental analysis
It is uncertain if these findings can be applied to the local population (i.e., Canada)

McIntosh, 2016²⁷

The research question, the viewpoint of the analysis, and the rationale for choosing the interventions stated
The form of economic evaluation is stated and justified in relation to the question addressed
The sources of effectiveness estimated are described
The primary outcome measure for the economic evaluation is clearly stated
Sources and methods used for estimating costs are stated
The currency used for all costs (i.e., 2010 Great British Pounds) was stated
Details of the models are given and the key parameters are justified
The time horizon is stated
Discount rate for annuitization of capital items was 3.5% (HM Treasury)
Details of statistical methods and approaches to sensitivity analyses are provided
The choice of variables for sensitivity analysis is justified; ranges for sensitivity analysis are provided
Incremental analysis is reported
The conclusions follow from the data reported and are clearly stated

The economic importance not described in introduction
The alternatives being compared (i.e., BMT) are not clearly described
It is uncertain if these findings can be applied to the local population (i.e., Canada)
Limitations of the report not described

From: Deep Brain Stimulation for Parkinson’s Disease: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

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Deep Brain Stimulation for Parkinson’s Disease: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines [Internet].

Lachance C, Spry C, MacDougall D.

Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2018 Dec 14.

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Table 8Strengths and Limitations of Economic Studies using the Drummond Checklist15

Table 8Strengths and Limitations of Economic Studies using the Drummond Checklist¹⁵