Interventions:
The intervention was relatively well reported and was appropriate in the authors' setting. It was compared with the usual practice. The population was described, but middle-class patients were not defined.
Effectiveness/benefits:
The effectiveness data were mainly from a published study. Little information was provided on the methods of this study, making it difficult to assess the validity of the effectiveness estimates. The study publication should be consulted to assess its validity. Life-years gained were an appropriate measure of benefit, but QALYs could have captured the impact of the intervention on quality of life, as well as allowing comparisons with other programmes. The authors acknowledged that not using QALYs might have limited their study.
Costs:
The costs appear to have reflected the perspective stated. The unit cost and resource use estimates were reported in detail, with the distributions used in the probabilistic sensitivity analyses. As the unit costs appear to have been from Argentina, the results might not be readily generalisable to other settings. The price year, discounting, and currency conversions were clearly reported.
Analysis and results:
The analytic approach used to synthesise the cost and outcome data was appropriate, and the results were sufficiently presented and discussed. The impact of uncertainty in the model parameters was investigated and discussed. The authors acknowledged some limitations to their analysis including that the source study for the effectiveness data was not a randomised controlled trial.
Concluding remarks:
The methods were good and the results were well reported. Some of the methods were not well reported, but the authors' conclusions appear to be appropriate for this study setting.
