Table A1.

Checklist Used for Critical Appraisal.

	Yes	No	N/A
Was a well-defined question posed in answerable form?
Did the study examine costs of the service(s) or programme(s)?
2.Did the study involve a comparison group?
3.Was a viewpoint for the analysis stated and was the study placed in any particular decision-making context?
4.Were the patient population and any relevant subgroups adequately defined?
Were all the important and relevant costs identified?
5.Was the range wide enough for the research question at hand?
6.Did it cover all relevant viewpoints? (Possible viewpoints include the community or social viewpoint, and those of patients and third-party payers. Other viewpoints may also be relevant depending upon the particular analysis.)
7.Were the capital costs, as well as operating costs, included?
Were costs measured accurately in appropriate physical units (e.g., hours of nursing time, number of physician visits, lost work-days)?
8.Were any of the identified items omitted from measurement? If so, does this mean that they carried no weight in the subsequent analysis?
9.Were there any special circumstances (e.g., joint use of resources) that made measurement difficult? Were these circumstances handled appropriately?
Were the costs valued credibly?
10.Were the sources of all values clearly identified? (Possible sources include market values, patient or client preferences and views, policy-makers’ views and health professionals’ judgements)?
11.Were market values employed for changes involving resources gained or depleted?
12.Where market values were absent (e.g., volunteer labour), or market values did not reflect actual values (such as clinic space donated at a reduced rate), were adjustments made to approximate market values?
Were costs adjusted for differential timing?
13.Were costs that occur in the future ‘discounted’ to their present values?
14.Was there any justification given for the discount rate used?
Was uncertainty in the estimates of costs adequately characterized?
15.If patient-level data on costs available, were appropriate statistical analyses performed?
16.Were the conclusions of the study sensitive to the uncertainty in the results, as quantified by the statistical analysis?
17.Was heterogeneity of the patient population recognized, for example by presenting study results for relevant subgroups?
Did the presentation and discussion of study results include all issues of concern to users?
18.Were the results compared with those of others who have investigated the same question? If so, were allowances made for potential differences in study methodology?
19.Did the study discuss the generalisability of the results to other settings and patient/client groups?
20.Were the implications of uncertainty for decision-making, including the need for future research, explored?