Grade Resource Use 2008 05 14

Resource use San Sebastián 14 May 2008 Pablo Alonso, Victor Montori, Andy Oxman, Holger Schünemann

A balance sheet is a simple but powerful way to present the advantages and disadvantages of the management options under consideration

What about the costs of compression stockings? ,[object Object]

B alance sheets should inform judgments about whether the net benefits are worth the incremental costs

Economic models versus balance sheets ,[object Object],[object Object],[object Object]

Important economic consequences should be included in SoF tables along with other important outcomes (whether or not an economic model is used) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

The perspective should be explicit ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

A broad perspective is desirable ,[object Object],[object Object],[object Object],[object Object]

Advantages of a broad perspective ,[object Object],[object Object],[object Object],[object Object]

Identifying resource consequences ,[object Object],[object Object]

Potentially important resource consequences

Identifying resource consequences ,[object Object],[object Object],[object Object],[object Object],[object Object]

Finding economic evidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Finding economic evidence ,[object Object],[object Object],[object Object],[object Object],[object Object]

If possible, resource use should be presented in natural units ,[object Object],[object Object],[object Object],[object Object]

Attaching monetary values to resource use ,[object Object],[object Object],[object Object],[object Object]

Attaching monetary values to resource use ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Appraising the quality of evidence for resource use ,[object Object],[object Object],[object Object]

Appraising the quality of evidence for resource use ,[object Object],[object Object]

Study limitations (risk of bias) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Inconsistency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Indirectness ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Imprecision ,[object Object],[object Object],[object Object],[object Object]

Publication bias ,[object Object],[object Object]

Using economic models to inform recommendations ,[object Object],[object Object],[object Object],[object Object],[object Object]

Using economic models to inform recommendations ,[object Object],[object Object],[object Object],[object Object]

The quality of the evidence used in economic models is rarely explicitly assessed ,[object Object],[object Object]

Cost per quality-adjusted life year (QALY) thresholds ,[object Object],[object Object],[object Object],[object Object]

Presenting the results of economic models together with SoF tables

When should resource use be presented? ,[object Object],[object Object]

When should resource use be presented? ,[object Object],[object Object],[object Object],[object Object],[object Object]

Even when – as in this case – cost/effect estimates are credible, they do not provide clear answers regarding appropriate action ,[object Object],[object Object],[object Object]

Strength of recommendation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Priority setting: From a health system or public health perspective A strong recommendation may not be important

Possible criteria for making a recommendation or a decision ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

From the perspective of individual patients and clinicians ,[object Object],[object Object],[object Object]

Should patients with partial epilepsy be treated with lamotrigine instead to carbamazepine?

Grade Resource Use 2008 05 14

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Grade Resource Use 2008 05 14