EVALUATION OF PE

LITERATURE
Phar 174
AY 2017 - 2018
Learning objectives

■ Identify points to consider when evaluating a

PE article
■ Evaluate a PE article
Evaluation of PE articles

Title Objective Alternatives

Description
of Perspective
alternatives
Evaluation of PE articles

Relevant Relevant
Type of study
costs outcomes

Analysis of Adjustment
costs and or
benefits discounting
Evaluation of PE articles

Sensitivity
Assumptions Limitations
analyses

Generalizations Conclusions
1. Complete title: Is the title
appropriate?
■ What is being compared and what type of
study is being conducted

■ Does the title sound biased?

■ Pharmacoeconomic Analysis of Glipizide
versus Glyburide in the Veterans
Administration
■ Cost-effectiveness Analysis of Two Antibiotic
Therapies in a Large Teaching Hospital
■ Ultraceph found Cost-effective when compared
to Megaceph
2. Clear objective: Is a clear
objective stated?
■ Must be clearly stated at the beginning of the
article
■ The objective of the study was to calculate the
benefit-to-cost ratio of pharmacists
interventions in the hospital
■ Our purpose was to perform an incremental
cost-utility analysis of standard chemotherapy
compared with palliative treatment alone for
patients with inoperable lung cancer
■ The objective of our study is to determine if
ultraceph is better than megaceph
3. Appropriate alternatives: Were
the appropriate alternatives or
comparators considered?

■ Most effective treatments or alternatives are

compared
■ Standard therapy
■ New treatment vs next best alternative
■ May be drug or non-drug treatments
4. Alternatives described: Was a
comprehensive description of
the competing alternatives
given?

■ Could another researcher replicate the study

based on information given?
■ Details on the alternatives being compared
5. Perspective stated: Is the
perspective of the study
addressed?

■ Perspective  whose costs are measured

■ Patient, hospital, clinic, insurance company, or
society
■ Results and recommendations will also vary
■ “The perspective of the study was…”
■ “Total third-party reimbursements for
prescription & medical services were
measured & summed”
■ “Costs to the Philippine health care system
were assessed”
6. Type of study: Is the type of
study stated?
■ Helps reader follow the rest of the research
article
■ May be a single or multiple types of study
7. Relevant costs: Were all the
important and relevant costs
included?
■ Based on stated perspective, were appropriate costs
assessed?
■ Were costs collected for an appropriate time period?
■ Costs estimated from other research should be
referenced
■ Author’s list should be compared with the reader’s
practice situation
7. Relevant costs: Were all the
important and relevant costs
included?
■ Was there justification for important
costs/consequences that were not included?
■ Protocol-driven costs & costs that are the same for
all alternatives should be excluded from
calculations
– Costs that occur because of the research
protocol of a RCT that would not occur in
everyday practice
8. Relevant outcomes: Were the
important or relevant
outcomes measured?
■ Are these the clinical outcomes that are
important to clinicians?
■ Were outcomes measured for an appropriate
time period?
■ Is the appropriate time period used?
Reduce
Diabetes Asthma
BP

Fasting blood FEV

Systolic BP
glucose measurements

Hemoglobin
Diastolic BP SFDs
A1C
9. Synthesis of costs and benefits: Was
a synthesis of costs and benefits
presented?

■ Presentation/ analysis of costs and benefits

■ Ratios, ICERs
10. Adjustment or discounting:
Was adjustment or discounting
appropriate? If so, was it
conducted?
■ Retrospective data  adjusted/ standardized
■ Costs and benefits extrapolated more than 1
year  calculate to present value
■ Discount rate to be used?
11. Reasonable assumptions: Are
assumptions stated and
reasonable?

■ Estimates used for costs, discount rate

■ Ask if estimates are reasonable in the context
of practice or decision-making process
12. Sensitivity analyses: Were
sensitivity analyses conducted
for important estimates or
assumptions?
■ Examine impact of assumptions to the study
conclusions
■ Determines if analysis is robust
■ Confidence to the results of the study
13. Limitations addressed: Were
limitations addressed?
■ Mention important limitations of the study
■ Retrospective data  selection bias
■ Small sample sizes or missing data may limit
statistical comparisons
14. Appropriate generalizations:
Were extrapolations beyond
the population studied proper?
■ Atypical population  generalizability of the
results
15. Unbiased conclusions: Was an
unbiased summary of the
results presented?
■ In general, do you believe the results of the
study?
■ Does the study make sense?
Evaluation of paper
Questions Answers
1. Is the title
appropriate?
2.
3.
4.
15.