Analytical Frameworks and Outcome Measures in Economic Evaluations of Digital Health Interventions: A Methodological Systematic Review
Benedetto, V (通讯作者),Univ Cent Lancashire UCLan, Appl Hlth Res Hub, Brook Bldg, Preston PR1 2HE, Lancs, England.;Benedetto, V (通讯作者),Natl Inst Hlth & Care Res Appl Res Collaborat Nor, Methodol Innovat Dev Adaptat & Support MIDAS Them, Liverpool, Merseyside, England.
Background Digital health interventions (DHIs) can improve the provision of health care services. To fully account for their effects in economic evaluations, traditional methods based on measuring health-related quality of life may not be appropriate, as nonhealth and process outcomes are likely to be relevant too. Purpose This systematic review identifies, assesses, and synthesizes the arguments on the analytical frameworks and outcome measures used in the economic evaluations of DHIs. The results informed recommendations for future economic evaluations. Data Sources We ran searches on multiple databases, complemented by gray literature and backward and forward citation searches. Study Selection We included records containing theoretical and empirical arguments associated with the use of analytical frameworks and outcome measures for economic evaluations of DHIs. Following title/abstract and full-text screening, our final analysis included 15 studies. Data Extraction The arguments we extracted related to analytical frameworks (14 studies), generic outcome measures (5 studies), techniques used to elicit utility values (3 studies), and disease-specific outcome measures and instruments to collect health states data (both from 2 studies). Data Synthesis Rather than assessing the quality of the studies, we critically assessed and synthesized the extracted arguments. Building on this synthesis, we developed a 3-stage set of recommendations in which we encourage the use of impact matrices and analyses of equity impacts to integrate traditional economic evaluation methods. Limitations Our review and recommendations explored but not fully covered other potentially important aspects of economic evaluations that were outside our scope. Conclusions This is the first systematic review that summarizes the arguments on how the effects of DHIs could be measured in economic evaluations. Our recommendations will help design future economic evaluations.