Interventions:
The interventions under study were well reported. No justification was given for the interventions chosen, but they would appear to be relevant in current settings.
Effectiveness/benefits:
The authors did not report any search methods or inclusion criteria for how published evidence was obtained. In addition, for data that were based on assumptions, no explanation was given as to how the authors arrived at the results. Consequently, it is not possible to determine if the best available evidence was used. The measure of benefit was the number of cases detected, which could have omitted other important health outcomes such as life expectancy and quality of life.
Costs:
The perspective adopted in the economic analysis was not explicitly reported. However, it would appear that a health care perspective was adopted, with productivity losses being included in the sensitivity analysis. All relevant major costs for this perspective appear to have been included in the analysis. The methods used to identify the cost data were well reported, with the authors also reporting the time horizon and price year used. However, although the costs could be incurred over a long time period, the authors did not report if discounting was applied.
Analysis and results:
Overall, insufficient details of the analytical approach were reported. The authors did not report the type of model used, nor did they give details or a graphical depiction. However, the results of the study were well reported, as were the results of the scenario analyses undertaken to test for uncertainty in the model. Although this type of analysis goes some way toward addressing parameter uncertainty, probabilistic sensitivity analysis is a more thorough way to fully capture uncertainty. Overall, the level of reporting, especially on the modelling and effectiveness parameters used, was unsatisfactory. The authors adequately reported the limitations of their study.
Concluding remarks:
Overall, the level of reporting of the methods was poor. Hence, it is difficult to judge the quality of the methodology used. The results were, however, adequately reported. Given the lack of reporting of methodology, the appropriateness of the authors’ conclusions is hard to assess.