Interventions:
The interventions were not reported in detail. For example, the medications used and their doses were not presented.
Effectiveness/benefits:
No systematic review of the literature was reported and the methods used to identify the primary sources were not reported. No details of the studies used for the effectiveness estimates were provided, such as the study population, study design etc. With this limited information, it is not possible to make an objective assessment of the validity of the estimates used. Little information was provided on the methods used to evaluate the utilities. As these utilities were evaluated for a different intervention, it is unclear whether these reflected the true utilities for the current population and interventions. QALYs are in general a validated measure of benefit and they allow cross-disease comparisons to be drawn.
Costs:
The reporting of the cost analysis was inadequate. The cost items included in the analysis, the resources use, and the unit costs were not reported in detail, making it difficult to assess whether these costs reflected the perspective stated. This means that the transparency of the analysis was limited. The price year was not reported, which will hinder future reflation exercises. The discounting was appropriate.
Analysis and results:
The synthesis of the costs and benefits was carried out appropriately, using incremental analysis. In general, the total costs and QALYs were not reported and only the differences between the two interventions were given. The sensitivity analysis was restricted to a deterministic approach and was limited to certain model parameters. The authors briefly discussed some limitations to their study.
Concluding remarks:
The study was not reported in detail, and the issue of uncertainty was only partially addressed. This makes it hard to assess the authors’ conclusions.