Evidence map›Paper›PMID 25533141›Full record

Observational studyBMC medical research methodology2014

Comparative efficiency research (COMER): meta-analysis of cost-effectiveness studies.

Carlos Crespo, Antonio Monleon, Walter Díaz, Martín Ríos

Abstract readObservational StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC medical research methodology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 22 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 22 syntheses or guidelines pooled it.

  1. Cost-effectiveness of renal denervation: a systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
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  2. Cost-efficiency of digital versus conventional workflow for removable complete dentures: A systematic review and meta-analysis.Journal of prosthodontics : official journal of the American College of Prosthodontists · 2026
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  6. Cost Effectiveness of Catheter Ablation Versus Antiarrhythmic Drugs for Atrial Fibrillation: A Systematic Review and Meta-analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Carlos CrespoStatistical Department, Facultat de Biologia, University of Barcelona, Avda Diagonal 645, 08028 Barcelona, Spain. ccrespo@ub.edu.
Antonio Monleon
Walter Díaz
Martín Ríos

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe aim of this study was to create a new meta-analysis method for cost-effectiveness studies using comparative efficiency research (COMER).

methodsWe built a new score named total incremental net benefit (TINB), with inverse variance weighting of incremental net benefits (INB). This permits determination of whether an alternative is cost-effective, given a specific threshold (TINB > 0 test). Before validation of the model, the structure of dependence between costs and quality-adjusted life years (QoL) was analysed using copula distributions. The goodness-of-fit of a Spanish prospective observational study (n = 498) was analysed using the Independent, Gaussian, T, Gumbel, Clayton, Frank and Placket copulas. Validation was carried out by simulating a copula distribution with log-normal distribution for costs and gamma distribution for disutilities. Hypothetical cohorts were created by varying the sample size (n: 15-500) and assuming three scenarios (1-cost-effective; 2-non-cost-effective; 3-dominant). The COMER result was compared to the theoretical result according to the incremental cost-effectiveness ratio (ICER) and the INB, assuming a margin of error of 2,000 and 500 monetary units, respectively.

resultsThe Frank copula with positive dependence (-0.4279) showed a goodness-of-fit sufficient to represent costs and QoL (p-values 0.524 and 0.808). The theoretical INB was within the 95% confidence interval of the TINB, based on 15 individuals with a probability > 80% for scenarios 1 and 2, and > 90% for scenario 3. The TINB > 0 test with 15 individuals showed p-values of 0.0105 (SD: 0.0411) for scenario 1, 0.613 (SD: 0.265) for scenario 2 and < 0.0001 for scenario 3.

conclusionsCOMER is a valid tool for combining cost-effectiveness studies and may be of use to health decision makers.

Indexed as

Comparative Effectiveness ResearchData Interpretation, StatisticalMeta-Analysis as TopicCost-Benefit AnalysisHumansProspective StudiesQuality-Adjusted Life Years

Identifiers

PMID25533141
PMCPMC4292992

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.