An evidence-based medicine approach to economic studies: assessing the cost-effectiveness of competing strategies for colorectal cancer screening

Abstract 

Cost-effectiveness analysis aims to quantitatively compare the expected outcomes of competing management strategies in environments with limited economic resources. A valid economic study models all relevant strategies from an appropriate perspective. The model must use costs that are accurately measured and strategies that have established clinical effectiveness, and appropriately integrate these data. The results should include the incremental cost-effectiveness ratio, which quantifies the resources required to achieve greater benefit with one strategy compared to another. A sensitivity analysis is required to determine whether uncertainty in assumptions alters the conclusions. Final interpretation of a cost-effectiveness analysis relies on whether costs and outcomes in the study can be realized in one’s own health care environment.

Abbreviations:  CEA, cost-effectiveness analysis, CRC, colorectal cancer, EBM, evidence-based medicine, FOBT, fecal occult blood test, FS, flexible sigmoidoscopy, HMO, health maintenance organization, ICER, incremental cost-effectiveness ratio, QALY, quality-adjusted life-years