Maniadakis 2006
Item	Dimension of quality	Question for critical appraisal	Yes	No	N/A	Comment
Structure
S1	Statement of decision problem/objective	Is there a clear statement of the decision problem?	x
		Is the objective of the evaluation and model specified and consistent with the stated decision problem?	x
		Is the primary decision‐maker specified?	x
S2	Statement of scope/perspective	Is the perspective of the model stated clearly?	x
		Are the model inputs consistent with the stated perspective?	x
		Has the scope of the model been stated and justified?	x
		Are the outcomes of the model consistent with the perspective, scope and overall objective of the model?	x
S3	Rationale for structure	Has the evidence regarding the model structure been described?	x			Referencing original study; Oostenbrink 2005
		Is the structure of the model consistent with a coherent theory of the health condition under evaluation?		x		The model does not include a health state of death
		Have any competing theories regarding model structure been considered?		x
		Are the sources of data used to develop the structure of the model specified?	x			Referencing original study; Oostenbrink 2005
		Are the causal relationships described by the model structure justified appropriately?	x
S4	Structural assumptions	Are the structural assumptions transparent and justified?	x
		Are the structural assumptions reasonable given the overall objective, perspective and scope of the model?	x
S5	Strategies/comparators	Is there a clear definition of the options under evaluation?	x
		Have all feasible and practical options been evaluated?	x
		Is there justification for the exclusion of feasible options?		x
S6	Model type	Is the chosen model type appropriate given the decision problem and specified causal relationships within the model?	x
S7	Time horizon	Is the time horizon of the model sufficient to reflect all important differences between options?		x
		Are the time horizon of the model, the duration of treatment and the duration of treatment effect described and justified?	x
		Has a lifetime horizon been used? If not, has a shorter time horizon been justified?		x
S8	Disease states/pathways	Do the disease states (state transition model) or the pathways (decision tree model) reflect the underlying biological process of the disease in question and the impact of interventions?	x
S9	Cycle length	Is the cycle length defined and justified in terms of the natural history of disease?	x
Data
D1	Data identification	Are the data identification methods transparent and appropriate given the objectives of the model?		x
		Where choices have been made between data sources, are these justified appropriately?			x	Not described
		Has particular attention been paid to identifying data for the important parameters in the model?	x
		Has the process of selecting key parameters been justified and systematic methods used to identify the most appropriate data?		x
		Has the quality of the data been assessed appropriately?	x			Referencing original study; Oostenbrink 2005
		Where expert opinion has been used, are the methods described and justified?			x
D2	Pre‐model data analysis	Is the data modelling methodology based on justifiable statistical and epidemiological techniques?	x
D2a	Baseline data	Is the choice of baseline data described and justified?	x			Described but not justified
		Are transition probabilities calculated appropriately?	x
		Has a half‐cycle correction been applied to both cost and outcome?		x
		If not, has this omission been justified?		x
D2b	Treatment effects	If relative treatment effects have been derived from trial data, have they been synthesised using appropriate techniques?			x	For each comparison data were derived from a single trial
		Have the methods and assumptions used to extrapolate short‐term results to final outcomes been documented and justified?	x
		Have alternative assumptions used to extrapolate short‐term results to final outcomes been explored through sensitivity analysis?		x
		Have assumptions regarding the continuing effect of treatment once treatment is complete been documented and justified?			x
		Have alternative assumptions regarding the continuing effect of treatment once treatment is complete been explored through sensitivity analysis?			x
D2c	Costs	Are the costs incorporated into the model justified?	x
		Has the source for all costs been described?	x
		Have discount rates been described and justified given the target decision‐maker?		x
D2d	Quality of life weights (utilities)	Are the utilities incorporated into the model appropriate?	x
		Is the source for the utility weights referenced?	x
		Are the methods of derivation for the utility weights justified?	x			Referencing original study; Oostenbrink 2005
D3	Data incorporation	Have all data incorporated into the model been described and referenced in sufficient detail?	x
		Has the use of mutually inconsistent data been justified (i.e. are assumptions and choices appropriate)?			x
		Is the process of data incorporation transparent?	x
		If data have been incorporated as distributions, has the choice of distribution for each parameter been described and justified?	x			Referencing original study; Oostenbrink 2005
		If data have been incorporated as distributions, is it clear that second order uncertainty is reflected?	x
D4	Assessment of uncertainty	Have the four principal types of uncertainty (D4a ‐ D4d below) been addressed?		x
		If not, has the omission of particular forms of uncertainty been justified?		x
D4a	Methodological	Have methodological uncertainties been addressed by running alternative versions of the model with different methodological assumptions?	x
D4b	Structural	Is there evidence that structural uncertainties have been addressed via sensitivity analysis?	x			Referencing original study; Oostenbrink 2005
D4c	Heterogeneity	Has heterogeneity been dealt with by running the model separately for different subgroups?		x
D4d	Parameter	Are the methods of assessment of parameter uncertainty appropriate?	x
		Has probabilistic sensitivity analysis been done? If, not has this been justified?	x
		If data are incorporated as point estimates, are the ranges used for sensitivity analysis stated clearly and justified?			x
Consistency
C1	Internal consistency	Is there evidence that the mathematical logic of the model has been tested thoroughly before use?	x
C2	External consistency	Are the conclusions valid given the data presented?	x
		Are any counterintuitive results from the model explained and justified?			x
		If the model has been calibrated against independent data, have any differences been explained and justified?		x
		Have the results of the model been compared with those of previous models and any differences in results explained?		x