SynthesisInternational journal of environmental research and public health2022
Challenges and Limitations in Distributional Cost-Effectiveness Analysis: A Systematic Literature Review.
Synthesis in International journal of environmental research and public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Methodological heterogeneity and equity challenges of distributional cost-effectiveness analysis in healthcare: a systematic review from 2017 to 2025.Archives of public health = Archives belges de sante publique · 2026Pooled it
- Value of Machine Learning Models for Cell-Free DNA-Based Multi-Cancer Early Detection: A Systematic Review and Meta-Analysis.Technology in cancer research & treatmentPooled it
- Evolving Treatment Options for Spinal Pain: Balancing Innovation and Affordability in Regenerative Medicine.Current pain and headache reports · 2026Review
- Economic Evaluation of Interventions for Children with Neurodevelopmental Disorders: Practical Guidance.PharmacoEconomics · 2026Review
- Economic Analyses of COVID-19 Interventions: A Narrative Review of Global Evidence.Healthcare (Basel, Switzerland) · 2025Review
- Aggregate Distributional Cost-Effectiveness Analysis of Biologics for the Treatment of Ankylosing Spondylitis in Chile.Applied health economics and health policy · 2025Article
- Application of distributional cost-effectiveness analysis methodology in real-world studies: a scoping review protocol.BMJ open · 2025Article
- Health Equity Considerations in Cost-Effectiveness Analysis: Insights from an Umbrella Review.ClinicoEconomics and outcomes research : CEOR · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCost-effectiveness is a tool to maximize health benefits and to improve efficiency in healthcare. However, efficient outcomes are not always the most equitable ones. Distributional cost-effectiveness analysis (DCEA) offers a framework for incorporating equity concerns into cost-effectiveness analysis.
objectiveThis systematic review aims to outline the challenges and limitations in applying DCEA in healthcare settings.
methodsWe searched Medline, Scopus, BASE, APA Psych, and JSTOR databases. We also included Google Scholar. We searched for English-language peer-reviewed academic publications, while books, editorials and commentary papers were excluded. Titles and abstract screening, full-text screening, reference list reviews, and data extraction were performed by the main researcher. Another researcher checked every paper for eligibility. Details, such as study population, disease area, intervention and comparators, costs and health effects, cost-effectiveness findings, equity analysis and effects, and modelling technique, were extracted. Thematic analysis was applied, focusing on challenges, obstacles, and gaps in DCEA.
resultsIn total, 615 references were identified, of which 18 studies met the inclusion criteria. Most of these studies were published after 2017. DCEA studies were mainly conducted in Europe and Africa and used quality health-adjusted measurements. In the included studies, absolute inequality indices were used more frequently than relative inequality indices. Every stage of the DCEA presented challenges and/or limitations.
conclusionThis review provides an overview of the literature on the DCEA in healthcare as well as the challenges and limitations related to the different steps needed to conduct the analysis. In particular, we found problems with data availability, the relative unfamiliarity of this analysis among policymakers, and challenges in estimating differences among socioeconomic groups.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.