Guideline topic: colonoscopic surveillance in polyps by Y Rajput
Cost-effectiveness modelling for colonoscopic surveillance in people with adenomas by K Jeong 2010
Section 1: ApplicabilityYes/ partly/ no/unclear/ NAComments
1.1 Is the study population appropriate for the guideline?Yes50-year old men and women who have adenomas removed at baseline colonoscopy with a high risk of developing colorectal cancer
1.2 Are the interventions appropriate for the guideline?YesAll clinically effective interventions/strategies included within the scope
1.3 Is the healthcare system in which the study was conducted sufficiently similar to the current UK NHS context?Yes
1.4 Are costs measured from the NHS and personal social services (PSS) perspective?Yes
1.5 Are all direct health effects on individuals included?PartlyQALY data from USA using standard gamble technique, there is very limited evidence available on the colorectal cancer stage-specific utility data
1.6 Are both costs and health effects discounted at an annual rate of 3.5%?Yes
1.7 Is the value of health effects expressed in terms of quality-adjusted life years (QALYs)?Yes
1.8 Are changes in health-related quality of life (HRQoL) reported directly from patients and/or carers?Yes
1.9 Is the valuation of changes in HRQoL (utilities) obtained from a representative sample of the general public?NoQALY data from USA using standard gamble technique used
1.10 Overall judgement: Directly applicable/partially applicable/not applicable There is no need to use section 2 of the checklist if the study is considered ‘not applicable’
Directly applicable
Other comments
Section 2: Study limitations (the level of methodological quality)
This checklist should be used once it has been decided that the study is sufficiently applicable to the context of the clinical guideline
Yes partly/no/unclear/NA CommentsComments
2.1 Does the model structure adequately reflect the nature of the health condition under evaluation?Yes
2.2 Is the time horizon sufficiently long to reflect all important differences in costs and outcomes?Yes45-year time horizon, uncertainty verified using different starting age of cohort (50, 55, 60, 65 years)
2.3 Are all important and relevant health outcomes included?Yes
2.4 Are the estimates of baseline health outcomes from the best available source?Yes
2.5 Are the estimates of relative treatment effects from the best available source?YesBest quality studies identified from clinical review
2.6 Are all important and relevant costs included?Yes
2.7 Are the estimates of resource use from the best available source?YesNHS specific
2.8 Are the unit costs of resources from the best available source?Yes
2.9 Is an appropriate incremental analysis presented or can it be calculated from the data?Yes
2.10 Are all important parameters whose values are uncertain subjected to appropriate sensitivity analysis?Yes
2.11 Is there no potential conflict of interest?No
2.12 Overall assessment: Minor limitations/potentially serious limitations/very serious limitations
Minor limitations

From: Appendix 8, Cost-effectiveness analysis of colonoscopic surveillance: adenomas

Cover of Colonoscopic Surveillance for Prevention of Colorectal Cancer in People with Ulcerative Colitis, Crohn's Disease or Adenomas
Colonoscopic Surveillance for Prevention of Colorectal Cancer in People with Ulcerative Colitis, Crohn's Disease or Adenomas.
NICE Clinical Guidelines, No. 118.
Centre for Clinical Practice at NICE (UK).
Copyright © 2011, National Institute for Health and Clinical Excellence.

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