Abstract:
PURPOSE:Cost-utility analysis is a type of cost-effectiveness analysis in which health effects are measured in terms of quality-adjusted life-years (QALYs) gained. Such analyses have become popular for examining the health and economic consequences of health and medical interventions, and they have been recommended by leaders in the field. These recommendations emphasize the importance of good reporting practices. This study determined 1) the quality of reporting in published cost-utility analyses through 1997 and 2) whether reporting practices have improved over time. We examined quality of reporting by journal type and number of cost-utility analyses a journal has published. DATA SOURCES:Computerized databases were searched through 1997 for the Medical Subject Headings or text keywords quality-adjusted, QALY, and cost-utility analysis. Published bibliographies of the field were also searched. STUDY SELECTION:Original cost-utility analyses written in English were included. Cost-effectiveness analyses that measured health effects in units other than QALYs and review, editorial, or methodologic articles were excluded. DATA EXTRACTION:Each of the 228 articles found was audited independently by two trained readers who used a standard data collection form to determine the quality of reporting in several categories: disclosure of funding, framing, reporting of costs, reporting of preference weights, reporting of results, and discussion. RESULTS:The number of cost-utility analyses in the medical literature increased greatly between 1976 and 1997. Analyses covered a wide range of diseases and interventions. Most studies listed modeling assumptions (82%), described the comparator intervention (83%), reported sensitivity analysis (89%), and noted study limitations (84%). Only 52% clearly stated the study perspective; 34% did not disclose the funding source. Methods of reporting costs and preference weights varied widely. The quality of published analyses improved slightly over time and was higher in general clinical journals and in journals that published more of these analyses. CONCLUSIONS:The study results reveal an active and evolving field but also underscore the need for more consistency and clarity in reporting. Better peer review and independent, third-party audits may help in this regard. Future investigations should examine the quality of clinical and economic assumptions used in cost-utility analyses, in addition to whether analysts followed recommended protocols for performance and reporting.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Neumann PJ,Stone PW,Chapman RH,Sandberg EA,Bell CMdoi
10.7326/0003-4819-132-12-200006200-00007subject
Has Abstractpub_date
2000-06-20 00:00:00pages
964-72issue
12eissn
0003-4819issn
1539-3704pii
200006200-00007journal_volume
132pub_type
杂志文章abstract:BACKGROUND:Variants in genes involved in warfarin metabolism and sensitivity affect individual warfarin requirements and the risk for bleeding. Testing for these variant alleles might allow more personalized dosing of warfarin during the induction phase. In 2007, the U.S. Food and Drug Administration changed the labeli...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-150-2-200901200-00005
更新日期:2009-01-20 00:00:00
abstract:OBJECTIVE:To describe 13 infections caused by Mycobacterium haemophilum. DESIGN:Identification of patients by microbiologic record review, followed by medical record review and a case-control study. SETTING:Seven metropolitan hospitals in New York. PATIENTS:All patients with M. haemophilum infections diagnosed betwe...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-120-2-199401150-00004
更新日期:1994-01-15 00:00:00
abstract:OBJECTIVE:To determine the toxicity and efficacy of low-dose interferon-alpha therapy in inducing remissions and prolonging survival in patients with chronic myeloid leukemia. DESIGN:Phase II evaluation and comparison with historical control patients and other series in which the investigators used higher interferon-a...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-121-10-199411150-00002
更新日期:1994-11-15 00:00:00
abstract:SOURCE CITATION:Mahady SE, Margolis KL, Chan A, et al. Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial. Gut. 2020. [Epub ahead of print.] 32747412. ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/ACPJ202101190-004
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the relation between weight variability and death in high-risk, middle-aged men participating in the Multiple Risk Factor Intervention Trial (MRFIT). DESIGN:Cohort study with 3.8 years of follow-up. SETTING:Multicenter, collaborative, primary prevention trial conducted at 22 clinical centers in ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-119-7_part_2-199310011-00024
更新日期:1993-10-01 00:00:00
abstract::The term functional somatic syndrome has been applied to several related syndromes characterized more by symptoms, suffering, and disability than by consistently demonstrable tissue abnormality. These syndromes include multiple chemical sensitivity, the sick building syndrome, repetition stress injury, the side effect...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-130-11-199906010-00016
更新日期:1999-06-01 00:00:00
abstract::Fifteen patients with chronic type B hepatitis were treated with corticosteroids in a randomized, double-blind, placebo-controlled trial lasting 28 days. Ten patients received prednisolone, 60 mg/d for 2 weeks, then 30 mg/d for another 2 weeks; 5 patients received placebo. Serum aminotransferase levels decreased signi...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-104-1-12
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:To estimate relative risk of mortality and median life expectancy for patients with classic hemophilia by a life-table analysis, taking into account deaths that may have occurred in infancy or childhood before the onset of symptoms. DESIGN:Retrospective chart review of clinical series. SETTING:Referral-base...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章
doi:10.7326/0003-4819-114-8-641
更新日期:1991-04-15 00:00:00
abstract::Recent national recommendations have proposed that physicians should titrate lipid therapy to achieve low-density lipoprotein (LDL) cholesterol levels less than 1.81 mmol/L (<70 mg/dL) for patients at very high cardiovascular risk and less than 2.59 mmol/L (<100 mg/dL) for patients at high cardiovascular risk. To exam...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-145-7-200610030-00010
更新日期:2006-10-03 00:00:00
abstract:BACKGROUND:Health care workers are at occupational risk for a vast array of infections that cause substantial illness and occasional deaths. Despite this, few studies have examined the incidence, prevalence, or exposure-associated rates of infection or have considered infection-specific interventions recommended to mai...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-125-10-199611150-00007
更新日期:1996-11-15 00:00:00
abstract:BACKGROUND:Risk for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to close contacts of infected persons has not been well estimated. OBJECTIVE:To evaluate the risk for transmission of SARS-CoV-2 to close contacts in different settings. DESIGN:Prospective cohort study. SETTING:Close con...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-2671
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To identify the cause of a hypersensitivity pneumonitis and to determine its pathogenesis. DESIGN:Case study. SETTING:Intensive care unit of a referral hospital. PATIENT:A 51-year-old man with chronic bronchitis who developed a hypersensitivity pneumonitis within 1 month after exposure to minocycline, amox...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-117-6-476
更新日期:1992-09-15 00:00:00
abstract:OBJECTIVE:To compare generalists' and cardiologists' estimates of baseline cardiovascular risk and the outcomes of preventive therapy. DESIGN:Cross-sectional mail survey using written case simulations of typical patients from primary prevention trials for hypercholesterolemia and isolated systolic hypertension, and te...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-124-4-199602150-00005
更新日期:1996-02-15 00:00:00
abstract:STUDY OBJECTIVE:To determine the effectiveness of chemotherapy and adjunctive surgery in managing patients with advanced seminoma. DESIGN:Nonrandomized prospective clinical trial of chemotherapy in a cohort of patients with advanced seminoma. SETTING:Referral cancer hospital. PATIENTS:Consecutive sample of 62 patien...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-4-513
更新日期:1988-04-01 00:00:00
abstract::The question of whether initial treatment is necessary in relatively asymptomatic patients with stage III and IV non-Hodgkin's lymphomas of favorable histologic types was studied by retrospective analysis. Two groups of patients were studied: [1] 44 nonprotocol patients, followed since 1963, in whom initial treatment ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-1-10
更新日期:1979-01-01 00:00:00
abstract::Despite some impressive recent gains, improving the glaring deficiencies in health care quality is proving to be very hard. Improvement is local, rather than system-wide, and is sustained with difficulty, rather than becoming an intrinsic feature of care. My right knee will probably need to be replaced soon. This has ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-142-2-200501180-00011
更新日期:2005-01-18 00:00:00
abstract:BACKGROUND:A common criticism of randomized, controlled trials (RCTs) is that the enrollment process may be highly selective and those who enroll may not represent persons in the general population. The recruitment process reported in published RCTs has not been systematically evaluated. OBJECTIVE:To determine whether...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-137-1-200207020-00007
更新日期:2002-07-02 00:00:00
abstract:BACKGROUND:Initiation of antiretroviral therapy (ART) during tuberculosis (TB) treatment remains challenging. PURPOSE:To assess evidence from randomized, controlled trials of the timing of ART initiation in HIV-infected adults with newly diagnosed pulmonary TB. DATA SOURCES:PubMed, EMBASE, Cochrane Central Register o...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/M14-2979
更新日期:2015-07-07 00:00:00
abstract:Background:In 1994, 40% of U.S. gun owners who had recently acquired a firearm did so without a background check. No contemporary estimates exist. Objective:To estimate the proportion of current U.S. gun owners who acquired their most recent firearm without a background check, by time since and manner of acquisition, ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M16-1590
更新日期:2017-02-21 00:00:00
abstract:Background:The presence of extracranial carotid disease (ECD) is associated with less favorable clinical outcomes in patients with acute ischemic stroke caused by intracranial proximal occlusion. Acute intra-arterial treatment (IAT) in the setting of extracranial and intracranial lesions is considered challenging, and ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/M16-1536
更新日期:2017-06-20 00:00:00
abstract::We studied D-penicillamine toxicity in 259 patients with systemic sclerosis treated since 1972. The average daily dose of 635 mg was given for a mean of 1.8 years. Of patients with systemic sclerosis, 47% has side effects from D-penicillamine treatment, similar to the 56% of 807 patients with rheumatoid arthritis in s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-104-5-699
更新日期:1986-05-01 00:00:00
abstract:OBJECTIVE:To assess the safety and efficacy of intravenous adenosine in terminating acute episodes of paroxysmal supraventricular tachycardia. DESIGN:Two prospective, double-blind, randomized, placebo-controlled trials to evaluate dose response in patients receiving adenosine and to compare the effects of adenosine wi...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-113-2-104
更新日期:1990-07-15 00:00:00
abstract:BACKGROUND:Observations that risk for colorectal cancer is elevated in patients with inflammatory bowel disease and that long-term use of anti-inflammatory drugs may reduce colorectal cancer risk have raised the possibility that inflammation may play a role in the development of colorectal cancer. While a recent prospe...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-142-6-200503150-00008
更新日期:2005-03-15 00:00:00
abstract:BACKGROUND:When deep venous thrombosis is suspected, objective testing is required to confirm or refute the diagnosis. OBJECTIVE:To determine whether the combination of a low clinical suspicion and a normal D -dimer result rules out deep venous thrombosis. DESIGN:Prospective cohort study. SETTING:Three tertiary care...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-135-2-200107170-00011
更新日期:2001-07-17 00:00:00
abstract:Background:Implantable cardioverter-defibrillators (ICDs) have a role in preventing cardiac arrest in patients at risk for life-threatening ventricular arrhythmias. Purpose:To compare ICD therapy with conventional care for the primary prevention of death of various causes in adults with ischemic or nonischemic cardiom...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/M17-0120
更新日期:2017-07-18 00:00:00
abstract:STUDY OBJECTIVE:To define the clinical and hematologic effects of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on patients with chronic severe neutropenia. DESIGN:Open-label, phase II study of rhGM-CSF. SETTING:Inpatient hematology and surgery clinic at a university medical center. P...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-11-887
更新日期:1989-12-01 00:00:00
abstract::Eighty-six patients who required heparin therapy were randomly assigned to receive bovine or porcine heparin. Abnormal concentrations of alanine transaminase and aspartate transaminase developed during treatment in 59.3% and 26.7% of patients, respectively. Patient characteristics that significantly influenced the dev...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-100-5-646
更新日期:1984-05-01 00:00:00
abstract:BACKGROUND:Travelers' diarrhea causes substantial morbidity and postinfectious irritable bowel syndrome. OBJECTIVE:To evaluate nonabsorbable rifaximin for prevention of travelers' diarrhea. DESIGN:Randomized, double-blind, placebo-controlled clinical trial. SETTING:Guadalajara, Mexico. PARTICIPANTS:U.S. students. ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-142-10-200505170-00005
更新日期:2005-05-17 00:00:00
abstract:OBJECTIVE:To determine whether a statistical association exists between "low-count" bacteriuria (> 10(2) to 10(4) colony-forming units/mL) and acute urinary symptoms in young women. DESIGN:Prospective, case-control study. SETTING:Gynecology clinic at a student health center. PATIENTS:Women with or without urinary or...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-119-6-199309150-00002
更新日期:1993-09-15 00:00:00
abstract:STUDY OBJECTIVE:To determine the usefulness of the continuous intravenous dexamethasone suppression test in the differential diagnosis of patients with the Cushing syndrome. DESIGN:Comparison of the results of this test with those of other tests in the study population and with data from the literature. SETTING:Refer...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-112-10-738
更新日期:1990-05-15 00:00:00