ReviewCost effectiveness and resource allocation : C/E2025
Handling uncertainty in cost-effectiveness analysis in dental medicine: a systematic review with a focus on affordability and risk-aversion.
Review in Cost effectiveness and resource allocation : C/E, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Discounting Practices in Cost-Effectiveness Analyses in Dentistry: A Systematic Review of Studies Published After 2020.ClinicoEconomics and outcomes research : CEOR · 2026Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe number of published cost-effectiveness analyses in dental medicine has substantially increased in recent years. A key methodological issue in these analyses is how to address uncertainty in costs and effects, which also impacts uncertainty around the expected cost-effectiveness ratio. The cost-effectiveness acceptability curve has become the standard method to summarize uncertainty in probabilistic cost-effectiveness analyses. However, it does not inform decision-makers about budget impact or account for the fact that they are often risk-averse. The cost-effectiveness affordability curve and the cost-effectiveness risk-aversion curve have been proposed to address these limitations. In this systematic review, we assess how uncertainty has been handled in cost-effectiveness analyses in dental medicine, with a particular focus on affordability and risk-aversion.
methodsWe conducted a systematic literature search across electronic databases (MEDLINE, Web of Science, Cochrane Library, EconLit, Embase) on April 18, 2025, and performed manual searches of selected references. Articles published after January 1, 2021, were included. From each study, we extracted information on the first author, year of publication, country, intervention evaluated, study design (model-based, trial-based, or combined), use of deterministic and/or probabilistic sensitivity analysis, and whether budget impact and risk-aversion were considered.
resultsFrom a total of 57 published cost-effectiveness analyses, 49 (85%) used a deterministic sensitivity analysis and 37 (65%) used a probabilistic sensitivity analysis. Budget impact analysis was performed in five studies (9%), and only one study formally applied both the cost-effectiveness affordability curve and the cost-effectiveness risk-aversion curve.
conclusionThe use of methods to address uncertainty related to budget constraints and risk-aversion remains limited in dental medicine. As decision-makers often operate within budget constraints and health is considered the most valuable good, incorporating methods that address affordability and risk-aversion could enhance the relevance and impact of cost-effectiveness analyses in dental care.
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Registered trials
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