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Characteristics and quality of pediatric cost-utility analyses

Abstract

Purpose  

Measuring utility for cost-utility analysis (CUA) is challenging in children. The objectives were to characterize pediatric
CUAs, appraise their quality, and identify determinants of higher quality.

Methods  

Descriptive data were imported from the PEDE database for 305 pediatric CUAs published from 1997 to 2009, and quality was
rated using the Pediatric Quality Appraisal Questionnaire (PQAQ) in 213 studies. The impact on quality of publication year,
journal type, and whether utility was measured was analyzed using multiple regression.

Results  

CUAs increased over time and the largest proportion was from North America (38%). Children aged 1–12 years (39%) and preventative
interventions (51%) were studied most frequently. Whereas a societal perspective was most common in papers published before
2007 (49%), a third-party payer perspective was subsequently most frequent (63%). Utility was measured prospectively in 8%
of studies. Domains that demonstrated the poorest quality were Perspective, Costs and resource use, Outcomes, Analysis, Incremental
analysis and Conflict of interest. Quality increased significantly over time for most domains and was greater in studies published
in methods/health economic journals.

Conclusions  

The quality of pediatric CUAs is increasing. Few studies ascertain utility prospectively, suggesting the need for better instruments
for pediatric health state valuation and measurement.

  • Content Type Journal Article
  • Pages 1-11
  • DOI 10.1007/s11136-011-0049-7
  • Authors
    • Seija K. Kromm, Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
    • Jennifer Bethell, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
    • Ferne Kraglund, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
    • Sarah A. Edwards, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
    • Audrey Laporte, Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
    • Peter C. Coyte, Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
    • Wendy J. Ungar, Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada