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Cited by 72Clinical practice guidelines implementationHealth Systems, Economic Evaluations, Quality of LifeHealth Policy Implementation Science

The Methodological Quality of Economic Evaluations of Guideline Implementation into Clinical Practice: A Systematic Review of Empiric Studies

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Hoomans, Ties, Evers, Silvia M.A.A., Ament, André J.H.A., Hübben, Mariette W.A., van der Weijden, Trudy, Grimshaw, Jeremy M., Severens, Johan L.·2007·Value in Health
DOI 10.1111/j.1524-4733.2007.00175.x
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Abstract

Objectives Despite the emphasis on efficiency of health-care services delivery, there is an imperfect evidence base to inform decisions about whether and how to develop and implement guidelines into clinical practice. In general, studies evaluating the economics of guideline implementation lack methodological rigor. We conducted a systematic review of empiric studies to assess advances in the economic evaluations of guideline implementation.Methods The Cochrane Effective Professional and Organisational Change Group specialized register and the MEDLINE database were searched for English publications between January 1998 and July 2004 that reported objective effect measures and implementation costs. We extracted data on study characteristics, quality of study design, and economic methodology. It was assessed whether the economic evaluations followed methodological guidance.Results We included 24 economic evaluations, involving 21 controlled trials and three interrupted time series designs. The studies involved varying settings, targeted professionals, targeted behaviors, clinical guidelines, and implementation strategies. Overall, it was difficult to determine the quality of study designs owing to poor reporting. In addition, most economic evaluations were methodologically flawed: studies did not follow guidelines for evaluation design, data collection, and data analysis.Conclusions The increasing importance of the value for money of providing health care seems to be reflected by an increase in empiric economic evaluations of guideline implementation. Because of the heterogeneity and poor methodological quality of these studies, however, the resulting evidence is still of limited use in decision-making. There seems to be a need for more methodological guidance, especially in terms of data collection and data synthesis, to appropriately evaluate the economics of developing and implementing guidelines into clinical practice.

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  • Two earlier reviews (Hoomans et al. 2007; Grimshaw et al. 2004) found evidence of limited quality and scope for understanding the cost-effectiveness of implementation strategies.

    “In two earlier reviews (Hoomans et al. in 2007 [3] and earlier Grimshaw et al. in 2004 [4]), the use of economic methods in evaluating the implementation of evidence-based guidelines was examined, and the authors found evidence of limited quality and scope for understanding the cost-effectiveness of implementation strategies.”

    From Use of health economic evaluation in the implementation and improvement science fields—a systematic literature review (2019) · cites this paper as [3]

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Authors
Hoomans, T., Evers, S. M. A. A., Ament, A. J. H. A., Hübben, M. W. A., van der Weijden, T., Grimshaw, J. M., & Severens, J. L.
Affiliations
Maastricht University (NL)
ORCID
Venue
Value in Health
Publisher
Elsevier BV
Published
2007-07
Volume
10
Issue
4
Pages
305-316
ISSN
1098-3015 (ISSN-L)
DOI
10.1111/j.1524-4733.2007.00175.x
OpenAlex
W2070550440
Cited by
71
References
60
Citations by year
2024: 5 · 2023: 5 · 2022: 5 · 2021: 3 · 2020: 8 · 2019: 8 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 2 · 2014: 3 · 2013: 5 · 2012: 1
FWCI
0.96
Type
journal article
Language
en
Open access
Licence
Locations
  • Value in Health (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
guideline implementation, economic evaluation, methodological quality, implementation costs, reporting quality, healthcare delivery efficiency, value for money, implementation strategies
MeSH terms
Diffusion of Innovation, Humans, Netherlands, Practice Management, Medical, Guideline Adherence, Empirical Research

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