Critical appraisal of published systematic reviews assessing the cost-effectiveness of telemedicine studies

Telemed J E Health. 2014 Jul;20(7):609-18. doi: 10.1089/tmj.2013.0259. Epub 2014 May 12.


Background: Over the last 10 years several systematic reviews have been published on the cost-effectiveness of telemedicine studies. Most reviews have concluded that there is not much difference in the cost-effectiveness when delivering health services via telemedicine or by conventional means. We are not aware of any systematic review looking at the systematic reviews of cost-effectiveness of telemedicine. This study was designed to identify published systematic reviews on the cost-effectiveness of telemedicine studies and to undertake a quality assessment of the identified systematic reviews.

Materials and methods: We searched six electronic databases, including Medline, Embase, and the NHS Economic Evaluation Database, combining "review" terms with "telemedicine" terms to identify systematic reviews.

Results: We identified 4,116 potential abstracts. Nine systematic reviews met the inclusion criteria, which looked at the cost-effectiveness of telemedicine in general. All reviews were similar in terms of their stated purpose, and the objectives were clear. Three of the reviews did not use a checklist for the economic evaluation studies included in their review. The quality assessment found that five of the nine reviews had minimal flaws.

Conclusions: Even though the general quality of reporting of the reviews was fine, we have found that conclusions cannot be drawn on the cost-effectiveness of telemedicine applications based on the methodological flaws in the economic analysis of the studies included in the reviews. Over time, reporting of cost-effectiveness has generally improved; however, there is still room for improvement, and authors need to use the recommended checklists for economic evaluations.

Keywords: cost-effectiveness; economics; systematic review; telemedicine.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Cost-Benefit Analysis / methods*
  • Female
  • Humans
  • Male
  • Publications / economics*
  • Publications / statistics & numerical data
  • Telemedicine / economics*
  • United Kingdom