W01 Introduction to search methods for health economics studies Exercise: Identifying economic evaluations using HEED Imagine you are conducting a Cochrane review of Pioglitazone for type 2 diabetes mellitus. You have decided to incorporate evidence on resource use, costs and cost- effectiveness into the review, and therefore wish to search for relevant economic Read the background information below, then conduct compound searches for relevant economic evaluation studies using HEED, and use the results of your search Type 2 diabetes mellitus is mainly characterised by a reduced ability of the hormone insulin to stimulate glucose uptake in body fat and muscles (insulin resistance) and affects most people suffering from diabetes. Several glucose-lowering medications are on the market to treat diabetes, amongst them pioglitazone. Pioglitazone is a thiazolidinedione (a class of oral antidiabetic medication), which is most often used to treat type 2 diabetes in its initial stages if lifestyle modifications (e.g. diet and exercise) have failed. Patients may receive pioglitazone in combination with other oral antidiabetic medication, insulin, and/or lifestyle modifications. Other oral antidiabetic medications include rosiglitazone and metformin. Types of studies • Cost-effectiveness analyses • Cost-utility analyses • Cost-benefit analyses • Cost analyses Types of interventions • Pioglitazone versus placebo. • Pioglitazone versus rosiglitazone or metformin (possibly with other combination • Pioglitazone in combination with rosiglitazone, metformin or insulin (possibly with other combination treatments) versus any other combination of rosiglitazone, metformin or insulin (possibly with other combination treatments). Search hints • Experiment with use of different HEED search terms to locate economic evaluations of pioglitazone that meet the above criteria for ‘Types of studies’ and ‘Types of interventions’. How does use of different search terms impact on the • Use the asterix (*) to truncate free-text search terms in the ‘Abstract’ or ‘All data’ search fields (e.g. pioglitazon* OR thiazolidinedion*). • ATC classifications: the Anatomical Therapeutic Chemical (ATC) classification system is used for the classification of drugs. It divides drugs into different groups according to the organ or system on which they act and/or their therapeutic and chemical characteristics. The ATC classifications for drugs used in diabetes are A10A (‘Insulins and analogues’), A10B (‘Blood glucose lowering drugs, excl. insulins’) and A10X (‘Other drugs used in diabetes’). • ICD-9 classifications: International Statistical Classification of Diseases and Related Health Problems (ICD) is the international standard diagnostic classification system used to classify diseases and other health conditions. The ICD-9 classification for diabetes mellitus is 250. • Experiment with using the browse function for the ‘Type Of Econ Eval’ search field to limit your search to different types of economic evaluation. 1. Once you have tried a few different combinations of search terms, select your preferred search and write it down. Why did you select your preferred 2. In the study ‘Economic evaluation of pioglitazone hydrochloride in the management of type 2 diabetes mellitus in Canada’ (Coyle et al, 2002): a. What type of economic evaluation is used? b. What is the discounted incremental cost per life-year gained of a first- line pioglitazone-based strategy compared with metformin? 3. How many articles report a cost-utility analysis that meets inclusion criteria for ‘Types of interventions’? (For each article you identify, please note down



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