Accepted Manuscript Evaluations of Health Economics in Radiation Oncology: A Systematic Review Timothy K. Nguyen, MD, Chris D. Goodman, BMSc, R. Gabriel Boldt, MSEd, MLIS, Andrew Warner, MSc, David A. Palma, MD, PhD, FRCPC, George B. Rodrigues, MD, PhD, FRCPC, Michael I. Lock, MD, FRCPC, Mark V. Mishra, MD, Gregory S. Zaric, PhD, Alexander V. Louie, MD, MSc, FRCPC PII:
S0360-3016(15)27197-0
DOI:
10.1016/j.ijrobp.2015.12.359
Reference:
ROB 23337
To appear in:
International Journal of Radiation Oncology • Biology • Physics
Received Date: 16 September 2015 Revised Date:
14 December 2015
Accepted Date: 15 December 2015
Please cite this article as: Nguyen TK, Goodman CD, Boldt RG, Warner A, Palma DA, Rodrigues GB, Lock MI, Mishra MV, Zaric GS, Louie AV, Evaluations of Health Economics in Radiation Oncology: A Systematic Review, International Journal of Radiation Oncology • Biology • Physics (2016), doi: 10.1016/ j.ijrobp.2015.12.359. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
EVALUATIONS OF HEALTH ECONOMICS IN RADIATION ONCOLOGY: A SYSTEMATIC REVIEW
RI PT
Timothy K. Nguyen, MD1; Chris D. Goodman, BMSc1; R. Gabriel Boldt, MSEd, MLIS2; Andrew Warner, MSc1; David A. Palma, MD, PhD, FRCPC1; George B. Rodrigues, MD, PhD, FRCPC1,3; Michael I. Lock, MD, FRCPC1; Mark V. Mishra, MD4; Gregory S.
SC
Zaric, PhD3,5; Alexander V. Louie, MD, MSc, FRCPC1,3
M AN U
1. Department of Radiation Oncology, London Regional Cancer Program, London, Canada
2. London Health Sciences Centre, London, Canada
3. Department of Epidemiology and Biostatistics, Western University, London, Canada
TE D
4. Department of Radiation Oncology, University of Maryland, Baltimore, USA 5. Ivey Business School, Western University, London, Canada Word count = 3465
EP
Running Title: Health Economics Radiation Oncology
AC C
Address Correspondence to: Dr. Alexander Louie
Department of Radiation Oncology London Regional Cancer Program 790 Commissioners Road East, Room A3-807 London, ON, Canada N6A 4L6
ACCEPTED MANUSCRIPT
Tel: (519) 685-8500 ext. 53025 Fax: (519) 685-8627
RI PT
E-mail: [email protected]
Conflict of Interest:
MVM has funding from the American Society for Radiation Oncology and served on the
SC
Patient Centered Outcomes Research Institute Patient Engagement Advisory Panel. AVL’s research is supported by the Western University Schulich Clinician-Scientist
AC C
EP
TE D
M AN U
award.
ACCEPTED MANUSCRIPT
SUMMARY Despite the increasing popularity of economic evaluations in radiation oncology, there is a lack of literature examining the quality of these studies. Through a systematic review of cost-
RI PT
utility and cost-effectiveness analyses involving radiotherapy, we found improvement in the reporting of key metrics with time, but overall reporting rates remain suboptimal. Although methodological approaches in this field of research are improving, additional attention to
AC C
EP
TE D
M AN U
SC
reporting guidelines is recommended.
1
ACCEPTED MANUSCRIPT
ABSTRACT Objective: Despite the rising costs in radiation oncology, the impact of health economics
RI PT
research on radiotherapy practice patterns is unclear. We performed a systematic review of costeffectiveness and cost-utility analyses (CEAs and CUAs) to identify trends in reporting quality in the radiation oncology literature over time.
Methods and Materials: A systematic review of radiation oncology economic evaluations up to
SC
2014 was performed using the MEDLINE and EMBASE databases. The CHEERS guideline informed data abstraction variables including study demographics, economic parameters, and
M AN U
methodological details. Tufts CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified into 3 time periods (1995-2004, 20052009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time.
Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement
TE D
(67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (p
S0360-3016(15)27197-0
DOI:
10.1016/j.ijrobp.2015.12.359
Reference:
ROB 23337
To appear in:
International Journal of Radiation Oncology • Biology • Physics
Received Date: 16 September 2015 Revised Date:
14 December 2015
Accepted Date: 15 December 2015
Please cite this article as: Nguyen TK, Goodman CD, Boldt RG, Warner A, Palma DA, Rodrigues GB, Lock MI, Mishra MV, Zaric GS, Louie AV, Evaluations of Health Economics in Radiation Oncology: A Systematic Review, International Journal of Radiation Oncology • Biology • Physics (2016), doi: 10.1016/ j.ijrobp.2015.12.359. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
EVALUATIONS OF HEALTH ECONOMICS IN RADIATION ONCOLOGY: A SYSTEMATIC REVIEW
RI PT
Timothy K. Nguyen, MD1; Chris D. Goodman, BMSc1; R. Gabriel Boldt, MSEd, MLIS2; Andrew Warner, MSc1; David A. Palma, MD, PhD, FRCPC1; George B. Rodrigues, MD, PhD, FRCPC1,3; Michael I. Lock, MD, FRCPC1; Mark V. Mishra, MD4; Gregory S.
SC
Zaric, PhD3,5; Alexander V. Louie, MD, MSc, FRCPC1,3
M AN U
1. Department of Radiation Oncology, London Regional Cancer Program, London, Canada
2. London Health Sciences Centre, London, Canada
3. Department of Epidemiology and Biostatistics, Western University, London, Canada
TE D
4. Department of Radiation Oncology, University of Maryland, Baltimore, USA 5. Ivey Business School, Western University, London, Canada Word count = 3465
EP
Running Title: Health Economics Radiation Oncology
AC C
Address Correspondence to: Dr. Alexander Louie
Department of Radiation Oncology London Regional Cancer Program 790 Commissioners Road East, Room A3-807 London, ON, Canada N6A 4L6
ACCEPTED MANUSCRIPT
Tel: (519) 685-8500 ext. 53025 Fax: (519) 685-8627
RI PT
E-mail: [email protected]
Conflict of Interest:
MVM has funding from the American Society for Radiation Oncology and served on the
SC
Patient Centered Outcomes Research Institute Patient Engagement Advisory Panel. AVL’s research is supported by the Western University Schulich Clinician-Scientist
AC C
EP
TE D
M AN U
award.
ACCEPTED MANUSCRIPT
SUMMARY Despite the increasing popularity of economic evaluations in radiation oncology, there is a lack of literature examining the quality of these studies. Through a systematic review of cost-
RI PT
utility and cost-effectiveness analyses involving radiotherapy, we found improvement in the reporting of key metrics with time, but overall reporting rates remain suboptimal. Although methodological approaches in this field of research are improving, additional attention to
AC C
EP
TE D
M AN U
SC
reporting guidelines is recommended.
1
ACCEPTED MANUSCRIPT
ABSTRACT Objective: Despite the rising costs in radiation oncology, the impact of health economics
RI PT
research on radiotherapy practice patterns is unclear. We performed a systematic review of costeffectiveness and cost-utility analyses (CEAs and CUAs) to identify trends in reporting quality in the radiation oncology literature over time.
Methods and Materials: A systematic review of radiation oncology economic evaluations up to
SC
2014 was performed using the MEDLINE and EMBASE databases. The CHEERS guideline informed data abstraction variables including study demographics, economic parameters, and
M AN U
methodological details. Tufts CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified into 3 time periods (1995-2004, 20052009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time.
Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement
TE D
(67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (p
