Adherence to the iDSI reference case among published cost-per-DALY averted studies

Emerson, J.; Panzer, A.; Cohen, J. T.; Chalkidou, K.; Teerawattananon, Y.; Sculpher, M.; Wilkinson, T.; Walker, D.; Neumann, P. J.; Kim, D. D.

doi:10.1101/432377

bioRxiv · 10.1101/432377

Adherence to the iDSI reference case among published cost-per-DALY averted studies

Emerson, J.·Panzer, A.·Cohen, J. T.·Chalkidou, K.·Teerawattananon, Y.·Sculpher, M.·Wilkinson, T.·Walker, D.·Neumann, P. J.·Kim, D. D.

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Abstract

BackgroundThe iDSI reference case, originally published in 2014, aims to improve the quality and comparability of cost-effectiveness analyses (CEAs). This study assesses whether the development of the guideline has improved the reporting and methodology for CEAs using disability-adjusted life-years (DALYs).\n\nMethodsWe analyzed the Tufts Medical Center Global Health CEA Registry to identify cost-per-DALY averted studies published from 2011 to 2017. Among each of 11 principles in the iDSI reference case, we translated all reporting standards and methodological specifications into quantifiable yes/no questions and awarded articles one point for each item satisfied. We then separately calculated reporting and methods scores, measured as percent adherence (0%=no adherence, 100%=full adherence). Using the year 2014 as the dissemination period, we conducted a pre-post analysis. Additionally, we conducted an analysis stratified by the 11 principles and examined different scoring strategies and dissemination periods in sensitivity analyses.\n\nResultsArticles averaged 74% adherence to reporting standards and 60% adherence to methodological specifications. Adherence to reporting standards increased slightly over time (72% pre-2014 vs. 75% post-2014, p<0.01), but methodological adherence did not significantly improve (59% pre-2014 vs. 60% post-2014, p=0.53). Overall, reporting adherence scores exceeded methodology adherence scores (74% vs. 60%, p<0.001). Articles seldom addressed budget impact (9% reporting, 10% methodology) or equity (7% reporting, 7% methodology).\n\nConclusionsThe iDSI reference case has substantial potential to serve as a useful resource for researchers and policy-makers in global health settings, but greater effort to promote adherence and awareness is needed to achieve its potential.

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Emerson, J., Panzer, A., Cohen, J. T., Chalkidou, K., Teerawattananon, Y., Sculpher, M., Wilkinson, T., Walker, D., Neumann, P. J., Kim, D. D.. 2018-10-01. Adherence to the iDSI reference case among published cost-per-DALY averted studies. https://doi.org/10.1101/432377

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