Table 2.
The Quality of Health Economic Studies (QHES) instrument
| Questions | Points | Yes/no | |
|---|---|---|---|
| 1. | Was the study objective presented in a clear, specific, and measurable manner? | 7 | |
| 2. | Were the perspective of the analysis (societal, third-party payer, etc.) and reasons for its selection stated? | 4 | |
| 3. | Were variable estimates used in the analysis from the best available source (i.e., randomized control trial—best, expert opinion—worst)? | 8 | |
| 4. | If estimates came from a subgroup analysis, were the groups prespecified at the beginning of the study? | 1 | |
| 5. | Was uncertainty handled by (1) statistical analysis to address random events, (2) sensitivity analysis to cover a range of assumptions? | 9 | |
| 6. | Was incremental analysis performed between alternatives for resources and costs? | 6 | |
| 7. | Was the methodology for data abstraction (including the value of health states and other benefits) stated? | 5 | |
| 8. | Did the analytic horizon allow time for all relevant and important outcomes? Were benefits and costs that went beyond 1 year discounted (3–5%) and justification given for the discount rate? | 7 | |
| 9. | Was the measurement of costs appropriate and the methodology for the estimation of quantities and unit costs clearly described? | 8 | |
| 10. | Were the primary outcome measure(s) for the economic evaluation clearly stated and were the major short-term, long-term, and negative outcomes included? | 6 | |
| 11. | Were the health outcomes measures/scales valid and reliable? If previously tested valid and reliable measures were not available, was justification given for the measures/scales used? | 7 | |
| 12. | Were the economic model (including structure), study methods and analysis, and the components of the numerator and denominator displayed in a clear, transparent manner? | 8 | |
| 13. | Were the choice of economic model, main assumptions, and limitations of the study stated and justified? | 7 | |
| 14. | Did the author(s) explicitly discuss direction and magnitude of potential biases? | 6 | |
| 15. | Were the conclusions/recommendations of the study justified and based on the study results? | 8 | |
| 16. | Was there a statement disclosing the source of funding for the study? | 3 | |
| Total points | |||