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Table 6 Summary of QHES instrument dimension scores

From: Use of health economic evaluation in the implementation and improvement science fields—a systematic literature review

QHES dimension Average score Highest possible score Percentage achieving highest possible score
Was the study objective presented in a clear, specific and measurable manner? 6.0 7 65%
Were the perspective of the analysis (societal, thirdparty, payer, etc.) and reasons for its selection stated? 2.4 4 28%
Were variable estimates used in the analysis from the best available source (i.e. randomised control trial—best, expert opinion—worst)? 7.4 8 83%
If estimates came from a subgroup analysis, were the groups prespecified at the beginning of the study? 0.4 1 33%
Was uncertainty handled by (1) statistical analysis to address random events, (2) sensitivity analysis to cover a range of assumptions? 5.8 9 33%
Was incremental analysis performed between alternatives for resources and costs? 5.4 6 94%
Was the methodology for data extraction (including the value of health states and other benefits) stated? 4.0 5 78%
Did the analytic horizon allow time for all relevant and important outcomes? Were benefits and costs that went beyond 1 year discounted (3% to 5%) and justification given for the discount rate? 4.7 7 39%
Was the measurement of costs appropriate and the methodology for the estimation of quantities and unit costs clearly described? 3.9 8 0%
Were the primary outcome measure(s) for the economic evaluation clearly stated and did they include the major short-term? Was justification given for the measures/scales used? 4.7 6 67%
Were the health outcomes measures/scales valid and reliable? If previously tested valid and reliable measures were not available, was justification given for the measures/scales used? 5.0 7 72%
Were the economic model (including structure), study methods and analysis, and the components of the numerator and denominator displayed in a clear, transparent manner? 6.7 8 83%
Were the choice of economic model, main assumptions, and limitations of the study stated and justified? 5.6 7 78%
Did the author(s) explicitly discuss direction and magnitude of potential biases? 3.9 6 56%
Were the conclusions/recommendations of the study justified and based on the study results? 8.0 8 100%
Was there a statement disclosing the source of funding for the study? 2.4 3 78%