Table 3 The QHES instrument

1.

Was the study objective presented in a clear, specific, and measurable manner?

7

2.

Were the perspective of the analysis (societal, third-party payer, etc.) and reasons for its selection stated?

4

3.

Were variable estimates used in the analysis from the best available source (i.e., randomized control trial - best, expert opinion - worst)?

8

4.

If estimates came from a subgroup analysis, were the groups prespecified at the beginning of the study?

1

5.

Was uncertainty handled by (1) statistical analysis to address random events, (2) sensitivity analysis to cover a range of assumptions?

9

6.

Was incremental analysis performed between alternatives for resources and costs?

6

7.

Was the methodology for data abstraction (including the value of health states and other benefits) stated?

5

8.

Did the analytic horizon allow time for all relevant and important outcomes? Were benefits and costs that went beyond 1 year discounted (3% to 5%) and justification given for the discount rate?

7

9.

Was the measurement of costs appropriate and the methodology for the estimation of quantities and unit costs clearly described?

8

10.

Were the primary outcome measure(s) for the economic evaluation clearly stated and did they include the major short-term, long-term, and negative outcomes?

6

11.

Were the health outcomes measures/scales valid and reliable? If previously tested valid and reliable measures were not available, was justification given for the measures/scales used?

7

12.

Were the economic model (including structure), study methods and analysis, and the components of the numerator and denominator displayed in a clear, transparent manner?

8

13.

Were the choice of economic model, main assumptions, and limitations of the study stated and justified?

7

14.

Did the author(s) explicitly discuss direction and magnitude of potential biases?

6

15.

Were the conclusions/recommendations of the study justified and based on the study results?

8

16.

Was there a statement disclosing the source of funding for the study?

3

Total Points

100