Interventions:
The level of reporting of interventions was good, supported by diagrams to communicate treatment pathways. It appeared that the relevant interventions were included. The authors suggested that the model was adaptable and other pathways (if viable) could be included.
Effectiveness/benefits:
The level of reporting of the effectiveness of benefits data was generally inadequate, so it was unclear whether the best sources of information were included in the model. The methods used to identify, select and pool relevant studies were not described by the authors, so it was unclear whether the best available evidence was used. The effectiveness data were presented in a table. The measurement of utilities was based on a published study and attributed utilities to a response score. The study population and methods used to estimate utilities were not reported, so it was unclear what methodology supported the calculation of QALYs. However, the aim of the authors was to develop an interactive model and the analysis presented may have been mainly for illustrative purposes.
Costs:
The authors did not specify a study perspective, although it appeared that the perspective of a local NHS commissioner was taken; the main costs relevant to this perspective were included. The reporting of the cost data was generally inadequate. The sources of resource use and prices were listed but not fully described. The authors did not report the price year or whether the costs had been adjusted. However, authors' aim should be considered when critically reviewing the outcomes.
Analysis and results:
The reporting of the model structure was good, supported by tables and diagrams. In the analysis presented, the use of an incremental approach was appropriate. However, the level of reporting of inputs and results was less transparent and compromised the generalisability and assessment of results. However, it was not the aim of the authors to present results, more to present an interactive model.
Concluding remarks:
The authors’ conclusions reflect the scope of the analysis in that they suggest that their interactive model may help in identifying optimal treatment pathways in the UK.