Evidence map›Paper›PMID 9794854›Full record

ReviewBMJ (Clinical research ed.)1998

Analysis and interpretation of cost data in randomised controlled trials: review of published studies.

J A Barber, S G Thompson

2 registry-linked trialsAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMJ (Clinical research ed.), 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 82 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
82citing papers in PubMed, 1 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.

NCT01141452 completednot on this mapstarted 2001, after this paper: background citation

Retrospective, Real-life Evaluation of the Effectiveness, Cost-effectiveness and Direct Healthcare Costs of Qvar Pressurised Metered-dose Inhaler (pMDI) Compared With Beclometasone Dipropionate pMDI and Fluticasone pMDI in the Management of Chronic Obstructive Pulmonary Disease (COPD) in a Representative UK Primary Care Patient Population

TypeobservationalSponsorResearch in Real-Life LtdRan2001 to 2007Enrolled815,377ConditionsChronic Obstructive Pulmonary DiseaseArmsExtra-fine hydrofluoroalkane beclomethasone MDI, Chlorofluorocarbon beclomethasone metered dose inhaler, Fluticasone propionate metred dose inhaler, Hydrofluoroalkane beclomethasone metred dose inhaler, Chlorofluorocarbon beclomethasone dipropionate
NCT01388374 nacompletednot on this mapstarted 2010, after this paper: background citation

A Study on the (Cost-)Effectiveness of Nurse Practitioners Working at the Primary Out of Hours Emergency Service and the Feasibility of Implementing These Nurses

TypeinterventionalSponsorRadboud University Medical CenterRan2010 to 2012Enrolled12,092ConditionsOut of Hours Medical Care, Primary Health CareArmsOther, care provided by Nurse Practitioners
3 · Its place in the literature

Who cites it

82 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  8. Cost Offset Associated With Early Start Denver Model for Children With Autism.Journal of the American Academy of Child and Adolescent Psychiatry · 2017
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  10. Impact of personality status on the outcomes and cost of cognitive-behavioural therapy for health anxiety.The British journal of psychiatry : the journal of mental science · 2016
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22 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

J A BarberDepartment of Medical Statistics and Evaluation, Imperial College School of Medicine, London W12 0NN. j.barber@rpms.ac.uk
S G Thompson

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo review critically the statistical methods used for health economic evaluations in randomised controlled trials where an estimate of cost is available for each patient in the study.

designSurvey of published randomised trials including an economic evaluation with cost values suitable for statistical analysis; 45 such trials published in 1995 were identified from Medline.

main outcome measuresThe use of statistical methods for cost data was assessed in terms of the descriptive statistics reported, use of statistical inference, and whether the reported conclusions were justified.

resultsAlthough all 45 trials reviewed apparently had cost data for each patient, only 9 (20%) reported adequate measures of variability for these data and only 25 (56%) gave results of statistical tests or a measure of precision for the comparison of costs between the randomised groups. Only 16 (36%) of the articles gave conclusions which were justified on the basis of results presented in the paper. No paper reported sample size calculations for costs.

conclusionsThe analysis and interpretation of cost data from published trials reveal a lack of statistical awareness. Strong and potentially misleading conclusions about the relative costs of alternative therapies have often been reported in the absence of supporting statistical evidence. Improvements in the analysis and reporting of health economic assessments are urgently required. Health economic guidelines need to be revised to incorporate more detailed statistical advice.

Indexed as

Cost-Benefit AnalysisCosts and Cost AnalysisData CollectionHealth Services ResearchRandomized Controlled Trials as TopicSample SizeSensitivity and Specificity

Identifiers

PMID9794854
PMCPMC28702

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.