Development of new reporting guidance for systematic reviews of health economic evaluations

Research question: This project seeks to develop a reporting guideline and checklist based on expert consensus that can improve the reporting quality of systematic reviews of health economic evaluations such that they better inform healthcare allocation decisions.

Background: Health economic evaluations are comparative analyses of alternative healthcare interventions in terms of their costs and consequences.

The quality of reporting of health economic evaluations remains variable, creating challenges for interpreting their methods and results.

This has motivated the development of reporting guidelines and checklists to improve the reporting of economic evaluations.

Nevertheless, no reporting guidance has been developed for systematic reviews of health economic evaluations despite their potential for informing policy and research.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline includes an evidence-based minimum item set for reporting of systematic reviews and meta-analyses, which has been extended to cover diverse study designs beyond intervention effectiveness studies. However, no such extension to PRISMA exists for systematic reviews of health economic evaluations.

Aims and objectives: This project aims to generate a PRISMA extension that serves as a new reporting guideline for systematic reviews of health economic evaluations (PRISMA-EE).

Specific project objectives adhere to scientifically rigorous requirements for developing health research reporting guidelines. Methods: A protocol for the PRISMA-EE extension will be developed and registered on the EQUATOR Network website.

A core international multidisciplinary working group will be established, composed of the co-applicants, and complemented by a member of the PRISMA executive, authors of systematic reviews of health economic evaluations, journal editors, and stakeholders including healthcare decision-makers and patient and public representatives.

An initial dataset of candidate reporting items will be identified and extracted from reviews of methodological literature, community-nominated examples and a purposive sample of systematic reviews of health economic evaluations. The working group will identify items that can be added, modified or removed to improve reporting quality.

Second, a multi-round online Delphi survey of a purposive sample of health economic evaluation and systematic review experts and stakeholders will be conducted to evaluate candidate reporting items included in PRISMA-EE.

The Delphi panelists will rate the importance of each item on a 9-point rating scale, comment on each, and suggest further items for subsequent rounds. Items will be categorised into Included , Possible and Rejected based on mean rating scores.

Sensitivity analyses will be conducted by three-tier respondent confidence, with mean rating scores calculated only from respondents who were most confident in their responses.

Third, a consensus meeting will be held to confirm the wording of included items, vote on possible items and agree on explanation of PRISMA-EE and its dissemination strategy. Finally, the checklist will be piloted by independent academic health economists and amended based on feedback. Timelines for delivery: The project will be conducted over a 12-month period, starting in October 2024.

Anticipated impact and dissemination: Involvement of PRISMA and experts in health economic evaluations and systematic reviews should ensure widespread dissemination and take-up of PRISMA-EE, with subsequent improvements in reporting quality of systematic reviews of health economic evaluations.