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August 28, 2002

Educating Authors and Reviewers of Economic Evaluations of Health Care—Reply

JAMA. 2002;288(8):959. doi:10.1001/jama.288.8.955

In Reply: Although we agree with Dr Gandjour that our review found a disappointing variable general quality of economic evaluations, his suggestions would have had little effect on our conclusions, since our primary focus was the methods used in the systematic reviews of economic evaluations, not the economic evaluations per se. Most of the instruments used in the reviews that we assessed did not include detailed consideration of methods of data aggregation, such as bootstrapping or Monte Carlo simulation, as these techniques have only been more commonly used in the last 4 years or so. However, some instruments, such as the BMJ checklist,1 do include a question on details of models used in the economic evaluation and on methods used to create parameters in the models used. In addition, the only review specifically assessing methods to handle uncertainty in economic evaluations, that by Briggs and Gray,2 showed that sensitivity analysis has rarely been adequately performed.

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