Table A7:

Methodological Quality of Studies Included in the Economic Evidence Review

Objective: To assess the cost-effectiveness of hearing implants
Author, Year	Does the model structure adequately reflect the nature of the health condition under evaluation?	Is the time horizon sufficiently long to reflect all important differences in costs and outcomes?	Are all important and relevant health outcomes included?	Are the estimates of relative treatment effects obtained from best available sources?	Do the estimates of relative treatment effect match the estimates contained in the clinical report?	Are all important and relevant (direct) costs included in the analysis?	Are the estimates of resource use obtained from best available sources?
Monksfield et al, 201162	N/A. Piggybacked evaluation	Yes. Lifetime	Partly	Partly. Small sample size; both HUI2 and HUI3 used	Unclear. Unclear if authors used individual utility data or the mean utility to derive QALYs	Partly	Yes

Author, Year	Are the unit costs of resources obtained from best available resources?	Is an appropriate incremental analysis presented or can it be calculated from the reported data?	Are all important and uncertain parameters subjected to appropriate sensitivity analysis?	Is there a potential conflict of interest?	Overall assessment including applicability to the project (Minor limitations/potentially serious limitations/very serious limitations)
Monksfield et al, 201162	Yes	Yes	No. Only deterministic sensitivity analyses for discount rates	No	Potentially serious limitations. Based on uncontrolled before-and-after study

Abbreviations: HRQOL, health-related quality of life; HUI2, Health Utilities Index Mark II questionnaire; HUI3, Health Utilities Index Mark III questionnaire; N/A, not applicable; QALY, quality-adjusted life-year.