Table A13:
Assessment of the Applicability of Studies Evaluating the Cost-Effectiveness of rTMS
| Author, Year, Country | Is the study population similar to the question? | Are the interventions similar to the question? | Is the health care system studied sufficiently similar to Ontario? | Were the perspectives clearly stated? If yes, what were they? | Are all direct effects included? Are all other effects included where they are material? | Are all future costs and outcomes discounted? If yes, at what rate? | Is the value of health effects expressed in terms of quality-adjusted life-years? | Are costs and outcomes from other sectors fully and appropriately measured and valued? | Overall Judgmenta |
|---|---|---|---|---|---|---|---|---|---|
| Fitzgibbon et al, 2019143 (Ontario, Canada) | Yes | Yes (Partially) rTMS followed by ECT versus ECT alone | Yes | Yes (perspective of Ontario Ministry of Health) | Yes | Yes (discount rate of 1.5%) | Yes | Yes | Partially applicable |
| HQO, 2014 (published 2016),13 Canadad | Yes | Yes (Partially) rTMS vs. ECT rTMS vs. sham | Yes | Yes (perspective of Ontario's Ministry of Health and Long-Term Care) | Yes | No (time horizon was 6 mo) | Yes | No | Partially applicable |
| University of Calgary, 2014,34 Canada | Yes | Yes rTMS vs. ECT rTMS vs. sham | Yes | Yes (perspective of Alberta's Ministry of Health) | Yes | No (time horizon was 3–6 mo) | Yes | No | Partially applicable |
| Zhao et al, 2017, Singapore144 | Yes | Yes rTMS vs. ECT | Partially | Yes (Societal perspective) | Yes | No (1-y time horizon) | Yes | Yes | Unclear |
| Voigt et al, 2017, USA145 | Partially (adults newly diagnosed with major depression, who failed to benefit from single-medication trial) | Yes (Partially) rTMS vs. medication | Yes | Yes (perspective of health care sector) | Yes | Yes (lifetime horizon) | Yes | Yes | Not applicable |
| Nguyen et al, 2015, Australia148 | Yes | Yes (partially) rTMS vs. medication | Yes | Yes (perspective of health care sector) | Yes | Yes (3-y time horizon) | Yes | No | Partially applicable |
| Vallejo-Torres et al, 2015, Spain149 | Yes | Yes (partially) ECT alone vs. rTMS alone vs. rTMS followed by ECT alone | Yes | Yes (perspective of health care sector) | Yes | No (time horizon was 1 y) | Yes | No | Partially applicable |
| Ghiasvand et al, 2016, Iran147 | Yes (partially, adults with major depression) | Yes (partially) rTMS vs. ECT | No | Yes (perspective of health care sector) | Yes | No (time horizon was 7 mo) | No | No | Not applicable |
Abbreviations: ECT, electroconvulsive therapy; HQO, Health Quality Ontario; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life-year; rTMS, repetitive transcranial magnetic stimulation; TRD, treatment-resistant depression.
Note: Response options for all items were “yes,” “partially,” “no,” “unclear,” and “NA” (not applicable).
a
Overall judgment could be “directly applicable,” “partially applicable,” or “not applicable.”