From: Micro-costing studies in the health and medical literature: protocol for a systematic review
1. | Author |
2. | Year of publication |
3. | Journal name |
4. | Research topic and study questions |
5. | Disease category: disease name, disease classification based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) chapters (for example, infectious and parasitic diseases, neoplasms, diseases of the circulatory system, and so on) |
6. | Study intervention(s) |
7. | Comparator intervention(s) |
8. | Study population/patient characteristics: age, gender, race/ethnicity, inclusion of vulnerable population, and so on |
9. | Study setting |
10. | Country/jurisdiction |
11. | Sample size |
12. | Year(s) of study |
13. | Study perspective: societal, healthcare system, hospital, healthcare program, and so on |
14. | Time horizon |
15. | Discounting |
16. | Price year |
17. | Inflation adjustment |
18. | Currency |
19. | Currency conversion |
20. | Type of economic analysis: cost effectiveness analysis, cost utility analysis, cost benefit analysis, cost minimization analysis, cost comparison analysis, cost outcome description, cost of illness study, and so on |
21. | Study type and design: randomized clinical trial, observational study, decision analytic modeling, other economic modeling, and so on |
22. | Economic outcome(s) |
23. | Health outcome(s) |
24. | Methods used to define effectiveness and preferences |
25. | Cost components included: personnel costs, consumables/materials/supplies cost, medication cost, facility cost, transportation cost, productivity loss, and so on |
26. | Separate reporting of input utilization quantity and unit cost data |
27. | Method of quantity data collection: time-motion study, patient self-report, cost-accounting database, provider/staff interview, and so on |
28. | Method of unit cost data collection: invoice amount, hospital/clinic/provider price catalogue, national/regional/provincial/hospital/insurer fee schedule, human resources/payroll record, and so on |
29. | Study assumption(s) |
30. | Sensitivity analyses performed: stochastic (probabilistic) sensitivity analysis, deterministic sensitivity analysis, or no sensitivity analysis |
31. | Whether the study referred to its own methodology as micro-costing |
32. | Comparison with other economic evaluation |
33. | Funding source: industry sponsored study, non-profit funding sources, no funding, or not specified |
34. | Conflict of interest: yes, no, or not reported |
35. | Notes (please record any additional features of the study that deserve consideration when evaluating its quality) |