The interventions were clearly reported. The study appears to have been thorough in its coverage of alternative interventions, including current practice.
The effectiveness data were derived from published studies, but no systematic search of the literature was reported. Although the sources of the literature were given neither the methods used to identify primary studies nor the inclusion criteria were reported. Therefore, it is difficult to ascertain if the best available evidence was used.
The utility values and their sources were clearly reported, but no details were provided on the methods of utility measurement. An assessment of the validity of these values is therefore not possible without recourse to the referenced studies.
: From the hospital perspective, it appears that all appropriate costs were included. However, there was no attempt to include productivity losses in order to adequately reflect the societal perspective. The unit costs, resource use, discounting adjustments for inflation, the price year, and all costing assumptions were clearly reported.
Analysis and results:
The model structure was presented graphically along with all the relevant details and modelling assumptions. The authors conducted an incremental analysis and the results were presented in sufficient detail. The methodology and the results of the sensitivity analyses were well presented, thus enhancing the generalisability of the findings. The authors provided a full discussion around the limitations of their study.
The quality of the study was satisfactory. Despite some limitations to the clinical data, the authors presented a reasonably transparent analysis and it is likely that the results reflected the available evidence.