A systematic review of health economic evaluations in orthotics and prosthetics: Part 1 - prosthetics

Prosthet Orthot Int. 2021 Feb;45(1):62-75. doi: 10.1177/0309364620935310.

Abstract

Background: The extent to which current prosthetic health economic evaluations inform healthcare policy and investment decisions is unclear. To further the knowledge in this area, existing evidence gaps and method design issues must be identified, thereby informing the design of future research.

Objectives: The aim of this systematic review was to identify evidence gaps, critical method design and reporting issues and determine the extent to which the literature informs a wide range of policy and investment decisions.

Study design: Systematic review.

Methods: A range of databases were searched using intervention- and health economic evaluation-related terms. Issues with methodological design and reporting were evaluated using the Consolidated Health Economic Checklist - Extended and the Checklist for Health Economic Evaluation Reporting Standards.

Results: The existing health economic evaluation literature was narrowly focused on informing within-participant component decisions. There were common method design (e.g. time horizon too short) and reporting issues (e.g. competing intervention descriptions) that limit the extent to which this literature can inform policy and investment decisions.

Conclusion: There are opportunities to conduct a wider variety of health economic evaluations to support within- and across-sector policy and investment decisions. Changes to aspects of the method design and reporting are encouraged for future research in order to improve the rigour of the health economic evaluation evidence.

Clinical relevance: This systematic review will inform the clinical focus and method design of future prosthetic health economic evaluations. It will also guide readers and policy-makers in their interpretation of the current literature and their understanding of the extent to which the current literature can be used to inform policy and investment decisions.

Publication types

  • Systematic Review

MeSH terms

  • Artificial Limbs*
  • Checklist
  • Cost-Benefit Analysis
  • Humans
  • Orthotic Devices
  • Prosthesis Implantation