Table A18:
Assessment of Limitations of Studies Evaluating the Cost-Effectiveness of TAVI Versus SAVR in Patients With Severe Aortic Stenosis at Low Surgical Risk
| Author, Country | Does the model structure adequately reflect the nature of the health condition under evaluation?a | Is the time horizon sufficiently long to reflect all important differences in costs and outcomes?a | Are all important and relevant health outcomes included?a | Are the clinical inputsb obtained from the best available sources?a | Do the clinical inputsb match the estimates contained in the clinical sources?a | Are all important and relevant (direct) costs included in the analysis?a | Are the estimates of resource use obtained from the best available sources?a | Are the unit costs of resources obtained from the best available sources?a | Is an appropriate incremental analysis presented, or can it be calculated from the reported data?a | Are all important and uncertain parameters subjected to appropriate sensitivity analysis?a | Is there a potential conflict of interest?a | Overall judgmentc |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Tam et al., 49 Canada | Yes | Yes, lifetime | Yes | Partially (QOL obtained from population at intermediate risk) | Yes | Yes | Yes | Yes | Yes | Partially (PSA, one other SA) | No | Minor limitations |
Abbreviations: PSA, probabilistic sensitivity analysis; QOL, quality of life; SA, sensitivity analysis; SAVR, surgical aortic valve replacement; TAVI, transaortic valve implantation.
a
Response options were “yes,” “partially,” “no,” “unclear,” and “not applicable.”
b
Clinical inputs include relative treatment effects, natural history, and utilities.
c
Overall judgment could be “minor limitations,” “potentially serious limitations,” or “very serious limitations.”