Evolución del gasto en servicios sanitarios antes y después del ictus isquémico: análisis de base poblacional / Trends in healthcare resource use and expenditure before and after ischaemic stroke. A population-based study

Introducción: A pesar del aumento de la supervivencia, el ictus representa una carga en salud y socioeconómica creciente. Mediante el uso de bases de datos poblacionales describimos las características principales de los pacientes con ictus isquémico y comparamos el uso de recursos y el gasto asociado un año antes y 3 años después del evento. Métodos: Se identificaron en los sistemas de Información del Servicio Catalán de la Salud todos los pacientes con ictus isquémico entre los años 2012 y 2016. Se relacionaron todos los contactos con el sistema sanitario desde un año antes del episodio índice hasta 3 años después. Se describió el uso de recursos y el gasto sanitario mensual y anual por paciente en los distintos recursos. Resultados: Se identificaron 36.044 pacientes con ictus isquémico, edad media (DE) de 74,7 (13,3) años. La supervivencia a los 3 años fue del 63%. El gasto medio por paciente en el año previo fue de 3.230€, de 11.060€ el primer año desde el ictus, de 4.104€ el segundo y 3.878€ el tercero. Los mayores determinantes de gasto en el primer año fueron las hospitalizaciones (incluyendo la hospitalización inicial), representando el 45% de la diferencia con respecto al año previo al ictus, y en segundo lugar el gasto en convalecencia y rehabilitación (un 33%). Después del primer año, los mayores determinantes del incremento en el gasto respecto al año previo fueron las nuevas hospitalizaciones y el tratamiento farmacológico. Conclusión: Después de un ictus isquémico, el gasto en atención sanitaria aumenta principalmente por las necesidades iniciales de hospitalización y después del primer año se reduce, aunque manteniéndose por encima de los valores previos al ictus. La información derivada de bases de datos poblacionales es útil para mejorar la organización de los servicios de atención al ictus. (AU)

Introduction: Despite improved survival rates, stroke represents an increasing healthcare and socioeconomic burden. We describe the main characteristics of patients with ischaemic stroke and resource use and associated expenditure one year before and 3 years after stroke, using a population-based dataset. Methods: The information technology systems of the Catalan Health Service were used to identify patients with ischaemic strokes occurring between January 2012 and December 2016. For each patient, information from one year before the stroke and up to 3 years thereafter was linked across databases. We describe annual and monthly resource use and healthcare expenditure per patient. Results: We identified 36,044 patients with ischaemic stroke (mean age, 74.7 ± 13.3 years). The survival rate at 3 years was 63%. Average expenditure per patient was €3,230 the year before stroke, €11,060 for year one after stroke, €4,104 for year 2, and €3,878 for year 3. The greatest determinants of cost in year one were hospitalisation (including initial hospitalisation), representing 45% of the difference in expenditure compared to the previous year, and convalescence and rehabilitation services, representing 33% of this difference. After year one, the increase in expenditure was mainly determined by additional hospital admissions and drug treatment. Conclusion: After ischaemic stroke, healthcare expenditure increases primarily because of initial hospitalisation. After year one, the expenditure decreases but remains above baseline values. Information from population-based datasets is useful for improving the planning of stroke services. (AU)

Trends in healthcare resource use and expenditure before and after ischaemic stroke. A population-based study.

INTRODUCTION: Despite improved survival rates, stroke represents an increasing healthcare and socioeconomic burden. We describe the main characteristics of patients with ischaemic stroke and resource use and associated expenditure one year before and 3 years after stroke, using a population-based dataset. METHODS: The information technology systems of the Catalan Health Service were used to identify patients with ischaemic strokes occurring between January 2012 and December 2016. For each patient, information from one year before the stroke and up to 3 years thereafter was linked across databases. We describe annual and monthly resource use and healthcare expenditure per patient. RESULTS: We identified 36 044 patients with ischaemic stroke (mean age, 74.7 ± 13.3 years). The survival rate at 3 years was 63%. Average expenditure per patient was €3230 the year before stroke, €11 060 for year 1 after stroke, €4104 for year 2, and €3878 for year 3. The greatest determinants of cost in year 1 were hospitalisation (including initial hospitalisation), representing 45% of the difference in expenditure compared to the previous year, and convalescence and rehabilitation services, representing 33% of this difference. After year one, the increase in expenditure was mainly determined by additional hospital admissions and drug treatment. CONCLUSION: After ischaemic stroke, healthcare expenditure increases primarily because of initial hospitalisation. After year one, the expenditure decreases but remains above baseline values. Information from population-based datasets is useful for improving the planning of stroke services.

Trends in healthcare resource use and expenditure before and after ischaemic stroke. A population-based study. / Evolución del gasto en servicios sanitarios antes y después del ictus isquémico: análisis de base poblacional.

INTRODUCTION: Despite improved survival rates, stroke represents an increasing healthcare and socioeconomic burden. We describe the main characteristics of patients with ischaemic stroke and resource use and associated expenditure one year before and 3 years after stroke, using a population-based dataset. METHODS: The information technology systems of the Catalan Health Service were used to identify patients with ischaemic strokes occurring between January 2012 and December 2016. For each patient, information from one year before the stroke and up to 3 years thereafter was linked across databases. We describe annual and monthly resource use and healthcare expenditure per patient. RESULTS: We identified 36,044 patients with ischaemic stroke (mean age, 74.7±13.3 years). The survival rate at 3 years was 63%. Average expenditure per patient was €3,230 the year before stroke, €11,060 for year one after stroke, €4,104 for year 2, and €3,878 for year 3. The greatest determinants of cost in year one were hospitalisation (including initial hospitalisation), representing 45% of the difference in expenditure compared to the previous year, and convalescence and rehabilitation services, representing 33% of this difference. After year one, the increase in expenditure was mainly determined by additional hospital admissions and drug treatment. CONCLUSION: After ischaemic stroke, healthcare expenditure increases primarily because of initial hospitalisation. After year one, the expenditure decreases but remains above baseline values. Information from population-based datasets is useful for improving the planning of stroke services.

[What kind of health information does the public need? Results of a qualitative study]. / ¿Qué necesidades de información de salud tienen la ciudadanía y los profesionales? Resultados de un estudio cualitativo.

INTRODUCTION: In 2016, the users of a Results Centre were asked directly about their health information needs. Three objectives were set: to define the groups interested in receiving the information generated, to determine the contents of the information to be included in the different products, and to identify the formats and channels most suitable for each of the stakeholders. MATERIAL AND METHODS: Semi-structured personal interviews and focus groups were organised to find out the interests of the users. Personal interviews and on-line consensus dynamics were also performed to determine the interests of the different health professionals, and those of professionals in communication. An analysis of content and discourse was done through the literal transcription of the focus groups and interviews held, as well as the open responses of the consensus dynamics. RESULTS: Two major interest groups were defined: that of professionals and of the users, with the former sub-divided into different groups according to their professional profile. The main contents of health information to include in the products generated differed for each interest group, as well as the most suitable formats and channels in each case. DISCUSSION: The information needs of professionals were oriented to the improvement of their professional practice. The importance of working on the dissemination of the information already generated, was also shown. The users stated that they only need information directly related to their health status, and identified their referring doctor as the person in charge of having this information and transmitting it.

Real World Data in Adaptive Biomedical Innovation: A Framework for Generating Evidence Fit for Decision-Making.

Analyses of healthcare databases (claims, electronic health records [EHRs]) are useful supplements to clinical trials for generating evidence on the effectiveness, harm, use, and value of medical products in routine care. A constant stream of data from the routine operation of modern healthcare systems, which can be analyzed in rapid cycles, enables incremental evidence development to support accelerated and appropriate access to innovative medicines. Evidentiary needs by regulators, Health Technology Assessment, payers, clinicians, and patients after marketing authorization comprise (1) monitoring of medication performance in routine care, including the materialized effectiveness, harm, and value; (2) identifying new patient strata with added value or unacceptable harms; and (3) monitoring targeted utilization. Adaptive biomedical innovation (ABI) with rapid cycle database analytics is successfully enabled if evidence is meaningful, valid, expedited, and transparent. These principles will bring rigor and credibility to current efforts to increase research efficiency while upholding evidentiary standards required for effective decision-making in healthcare.

Evaluación económica de intervenciones en enfermedades oncológicas en España: revisión sistemática y análisis comparativo / Economic evaluation of interventions for malignant neoplasms in Spain: systematic review and comparative analysis

Objetivo Revisar los métodos utilizados para elaborar evaluaciones económicas de intervenciones en enfermedades oncológicas y comparar sus principales características con las de los estudios dirigidos a otras enfermedades. Métodos Revisión sistemática y análisis comparativo calculando odds ratios (OR). Se realizaron búsquedas bibliográficas para identificar las evaluaciones económicas sobre enfermedades oncológicas realizadas en España entre 1983 y 2008. Se revisaron y describieron sus características, incluyendo las siguientes variables: revista y año de publicación, intervención, tipo de estudio, diseño, perspectiva, tipo de costes, fuente de financiación, y si se presentaban (o no) recomendaciones. Resultados Se incluyeron 63 estudios. Principalmente, resultaron ser análisis coste-efectividad y evaluaban tratamientos (60,3%; n=38). Diecisiete estudios (27,0%) utilizaron un diseño observacional. Los trabajos sobre enfermedades oncológicas mostraron las siguientes asociaciones (respecto a los estudios en otras causas [n=411]) con: análisis de minimización de costes (OR=1,73; intervalo de confianza [IC] del 95%: 0,91-3,27), diagnóstico (OR=2,18; IC95%: 1,07-4,43), análisis de decisiones (OR=0,46; IC95%: 0,24-0,87), perspectiva social (OR=0,20; IC95%: 0,05-0,86) y fuente de financiación con ánimo de lucro (OR=0,52; IC95%: 0,30-0,93).Conclusiones El número de evaluaciones económicas es escaso a pesar del aumento progresivo producido en los últimos años. Los estudios identificados presentaron heterogeneidad en cuanto a los métodos y las fuentes de información utilizadas. Es necesario aumentar la evaluación de la eficiencia de intervenciones oncológicas y garantizar su calidad metodológica (AU)

Objective To review standard methods used to evaluate the efficiency of oncology interventions, comparing their main characteristics with those of the studies aimed for other conditions. Methods We performed a systematic review and comparative analysis calculating odds ratios (OR). We searched the biomedical literature to assess economic evaluation studies on malignant neoplasms in Spain published between 1983 and 2008. Their characteristics were reviewed and summarised, including the following variables: journal and year of publication, intervention, type and design of study, perspective, type of costs, financing source, and decision-making recommendations. Results Sixty-three studies were included. Main characteristics of the reports were: cost-effectiveness analysis and therapeutic interventions (60.3%; n=38). Seventeen studies (27.0%) used an observational design. Economic evaluations of malignant neoplasms showed the following associations (compared to those studies addressing other causes [n=411]): cost minimisation analysis (OR: 1.73; 95% confidence interval [CI]: 0.91-3.27), diagnostic interventions (OR: 2.18; 95% CI: 1.07-4.43), decision analysis design (OR: 0.46; 95% CI: 0.24-0.87), societal perspective (OR: 0.20; 95% CI: 0.05-0.86) and for-profit source of financing (OR: 0.52; 95% CI: 0.30-0.93). Conclusions Economic evaluations of interventions for malignant neoplasms are not common despite the gradual increase produced during recent years in Spain. Reports presented heterogeneity in the quality of the information regarding the methods and the data sources used. Further efficiency evaluations of oncology interventions are needed and methodological quality should be warranted (AU)

Economic evaluation of interventions for malignant neoplasms in Spain: systematic review and comparative analysis.

OBJECTIVE: To review standard methods used to evaluate the efficiency of oncology interventions, comparing their main characteristics with those of the studies aimed for other conditions. METHODS: We performed a systematic review and comparative analysis calculating odds ratios (OR). We searched the biomedical literature to assess economic evaluation studies on malignant neoplasms in Spain published between 1983 and 2008. Their characteristics were reviewed and summarised, including the following variables: journal and year of publication, intervention, type and design of study, perspective, type of costs, financing source, and decision-making recommendations. RESULTS: Sixty-three studies were included. Main characteristics of the reports were: cost-effectiveness analysis and therapeutic interventions (60.3%; n=38). Seventeen studies (27.0%) used an observational design. Economic evaluations of malignant neoplasms showed the following associations (compared to those studies addressing other causes [n=411]): cost minimisation analysis (OR: 1.73; 95% confidence interval [CI]: 0.91-3.27), diagnostic interventions (OR: 2.18; 95% CI: 1.07-4.43), decision analysis design (OR: 0.46; 95% CI: 0.24-0.87), societal perspective (OR: 0.20; 95% CI: 0.05-0.86) and for-profit source of financing (OR: 0.52; 95% CI: 0.30-0.93). CONCLUSIONS: Economic evaluations of interventions for malignant neoplasms are not common despite the gradual increase produced during recent years in Spain. Reports presented heterogeneity in the quality of the information regarding the methods and the data sources used. Further efficiency evaluations of oncology interventions are needed and methodological quality should be warranted.

[Economic evaluation of interventions for infectious diseases in Spain: systematic review and comparative analysis]. / Evaluación económica de intervenciones en enfermedades infecciosas en España: revisión sistemática y análisis comparativo.

BACKGROUND: There exists the need to evaluate interventions addressed to prevent, control and reduce the burden of the infectious diseases; being economic evaluation an instrument can help to allocate healthcare resources efficiently. In this context, we assessed the evolution of economic evaluation of interventions for infectious diseases published in Spain, as well as we compared their main methodological characteristics with those of the studies directed to other diseases. METHODS: Systematic review and comparative analysis calculating odds ratios (OR). Electronic searches for literature beetwen 1983 and 2008 were conducted in PubMed/MEDLINE, SCOPUS, ISI Web of Knowledge, CRD, IME e IBECS, and manually in specialized journals and technical reports. The following variables were identified to analyze the characteristics of the reports: journal and year of publication, intervention, type of study, design, perspective, type of costs, financing source, and decision-making recommendations. RESULTS: One-hundred and one studies were included in the review. The main characteristics of the reports were: cost-effectiveness analysis (n=56; 55.4%), treatments evaluations (n=60; 59.4%) and the use of decision analysis and mathematical simulation models (n=63; 62.4%). Economic evaluation studies of infectious diseases showed the following associations (compared to a cohort of studies of other disease conditions [n=376]): cost-benefit analysis (OR, 3.55; 95% confidence interval [CI], 1.63 to 7.74), prevention (OR, 4.14; 95% CI, 2.49 to 6.90), and societal perspective (OR, 2.55; 95% CI, 1.43 to 4.56). CONCLUSION: Although there is an increase in the number of economic evaluations of infectious diseases published during last decades, the studies showed heterogeneity in the quality of the information regarding methods of analysis and data sources.

A systematic review of cost-effectiveness evidence of endoscopic saphenous vein harvesting: is it efficient?

OBJECTIVE: Greater saphenous vein harvest for coronary and lower extremity bypass requires the longest incision of any surgical procedure. Endoscopic vein harvest allows better results in some clinical variables compared to open harvesting techniques. The objective of this study is to present the results of a systematic review of the scientific evidence about the efficiency of endoscopic saphenous vein harvest. METHODS: We performed a systematic review in the bibliographical databases Pubmed, National Health Service Economic Evaluation Database, and NHS Health Technology Assessment Database. The search strategy was "endoscopic AND harvesting", in the period January 1970-December 2009. RESULTS: We identified only 3 economic evaluation studies, 2 cost analyses with some methodological limitations, and 1 cost-utility analysis. All of them suggest lower hospital costs for endoscopic harvesting. CONCLUSIONS: Available evidence does not allow recommendations to be made based on the efficiency of endoscopic saphenous vein harvest, although it suggests lower costs for endoscopic harvesting. More scientific evidence about the long-term efficacy and the effectiveness of this technique is necessary, with studies measuring final outcomes, and carrying out complete and rigorous economic evaluations.

[Economic evaluation of neurological and mental disorders in Spain: systematic review and comparative analysis]. / Evaluacion economica sobre enfermedades neurologicas y mentales en Espana: revision sistematica y analisis comparativo.

AIM: We analyzed the trends over time and the characteristics of economic evaluation studies of neurological and mental disorders published in Spain between 1983 and 2008. MATERIALS AND METHODS: Systematic review and comparative analysis calculating odds ratios (OR). Electronic searches for literature were conducted in PubMed/Medline, Scopus, ISI Web of Knowledge, CRD, IME and IBECS, and manually in specialized journals and technical reports. RESULTS: The 52 studies included in the review showed heterogeneity in the quality of the information regarding methods of analysis and data sources. Economic evaluation studies of neurological and mental disorders showed the following associations, compared to a cohort of studies of other disease conditions (n = 425): cost-utility analysis (OR = 1.57; 95% confidence interval, 95% CI = 0.77-3.22), treatments (OR = 3.02; 95% CI = 1.33-6.88), simulation mathematics models (OR = 2.51; 95% CI = 1.30-4.87), and healthcare system perspective (OR = 1.43; 95% CI = 0.80-2.54). CONCLUSIONS: Findings suggested that there is little research on economic evaluation research on neurological and mental disorders in Spain. In the future, more and better quality economic evaluation studies -according to their burden generated- are expected.

Evaluación económica sobre enfermedades neurológicas y mentales en España: revisión sistemática y análisis comparativo / Economic evaluation of neurological and mental disorders in Spain: systematic review and comparative analysis

Objetivo. Analizar la evolución y las características metodológicas de los estudios de evaluación económica sobre enfermedades neurológicas y mentales publicados en España entre 1983 y 2008. Materiales y métodos. Revisión sistemática y análisis comparativo calculando odds ratios (OR). Se realizaron búsquedas de estudios publicados en PubMed/Medline, Scopus, ISI Web of Knowledge, CRD, IME e IBECS, y además manualmente en revistas especializadas e informes técnicos. Resultados. Los 52 estudios incluidos en la revisión combinan heterogeneidad en la calidad de la información comunicada respecto a los métodos de análisis y las fuentes de datos. Los trabajos sobre enfermedades neurológicas y mentales mostraron las siguientes asociaciones, respecto a los estudios en otras causas (n = 425): con análisis coste-utilidad (OR = 1,57; intervalo de confianza del 95%, IC 95% = 0,77-3,22), tratamientos (OR = 3,02; IC 95% = 1,33-6,88), modelos matemáticos de simulación (OR = 2,51; IC 95% = 1,30-4,87) y perspectiva del sistema sanitario (OR = 1,43; IC 95% = 0,80-2,54). Conclusiones. Se observa que hay poca investigación en evaluación económica sobre enfermedades neurológicas y mentales en España. Sería de esperar que en el futuro aumentara el número de estudios en enfermedades neurológicas y mentales –en relación con la carga de enfermedad que generan– y su calidad metodológica (AU)

Aim. We analyzed the trends over time and the characteristics of economic evaluation studies of neurological and mental disorders published in Spain between 1983 and 2008. Materials and methods. Systematic review and comparative analysis calculating odds ratios (OR). Electronic searches for literature were conducted in PubMed/Medline, Scopus, ISI Web of Knowledge, CRD, IME and IBECS, and manually in specialized journals and technical reports. Results. The 52 studies included in the review showed heterogeneity in the quality of the information regarding methods of analysis and data sources. Economic evaluation studies of neurological and mental disorders showed the following associations, compared to a cohort of studies of other disease conditions (n = 425): cost-utility analysis (OR = 1.57; 95% confidence interval, 95% CI = 0.77-3.22), treatments (OR = 3.02; 95% CI = 1.33-6.88), simulation mathematics models (OR = 2.51; 95% CI = 1.30-4.87), and healthcare system perspective (OR = 1.43; 95% CI = 0.80-2.54). Conclusions. Findings suggested that there is little research on economic evaluation research on neurological and mental disorders in Spain. In the future, more and better quality economic evaluation studies –according to their burden generated– are expected (AU)

Meta-analysis of passive immunoprophylaxis in paediatric patients at risk of severe RSV infection.

AIM: To review respiratory syncytial virus (RSV), passive immunoprophylaxis (PI) trials and meta-analysis (MA). METHODS: A literature review. RESULTS: Two MA of PI were found. Overall 3927 patients were randomized. PI reduces RSV hospitalization in patients with bronchopulmonary dysplasia (RR 0.58; 95% CI 0.41, 0.82) and with acyanotic congenital heart disease (RR 0.29; 95% CI 0.14, 0.62). In patients with cyanotic heart disease or premature infants without bronchopulmonary dysplasia, results are inconclusive. Passive immunoprophylaxis has a null effect in mechanical ventilation and death. CONCLUSION: Passive immunoprophylaxis reduces RSV hospitalization in a subset of patients. However, it has no effect in harder endpoints of RSV disease severity.

The economic cost of road traffic crashes in an urban setting.

The objective of this article is to assess the total economic costs of road traffic crashes in Barcelona, a metropolitan city located in Southern Europe. A cost-of-illness study was conducted using a prevalence approximation, a societal and healthcare system perspective, and a 1-year time horizon. Results were measured in terms of Euros in 2003. Total costs of road traffic crashes in Barcelona in 2003 were euro367 million. Direct costs equalled euro329 million (89.8% of total costs), including property damage costs, insurance administration costs and hospital costs. Police, emergency costs and transportation costs had a minimum effect on total direct costs. Indirect costs were euro37 million, including lost productivity due to hospitalization and mortality. The results of the sensitivity analysis showed the upper limit of total economic cost of road traffic crashes in Barcelona to be euro782 million. This is the first study to estimate the costs of road traffic crashes for a city in a developed country. The importance of the problem calls for further interventions to reduce road traffic crashes.

Twenty years of health care economic analysis in Spain: are we doing well?

The rising demand for health care, together with the scarce available resources, has increased the use of economic analysis as a support tool for policy making. The objective of this study was to make a description of economic evaluation studies carried out in Spain and published during the last 20 years, and to assess their quality. A systematic bibliographic search was made in the main biomedical databases. Full economic evaluation studies made in Spain comparing two or more health care alternatives were included. Statistical analyses included a descriptive analysis, the assessment of the association between pairs of variables, and a homogeneity analysis. A total of 87 studies were included in the review. According to the methodology, the technique most frequently used was cost-effectiveness analysis. In most cases, some weaknesses could be pointed out: absence of any objective directly linked to the decision-making process, a non-explicit perspective, no inclusion of indirect costs, or clinical and economical data not concurrently collected. A continuing challenge for health care economic analysis in Spain is to follow methodological guidelines and reporting conventions, to improve the dissemination of research, as well as to use more sophisticated economic analysis techniques, and to publish in international journals.

Screening and clinical management of prostate cancer. A cross-national comparison.

OBJECTIVES: The objectives of the study were to identify the current standards of clinical practice regarding prostate cancer screening in western Europe, Canada, and the United States, and to highlight major characteristics of current prostate cancer screening programs or patterns of practice. METHODS: We performed a semi-structured interview by means of a self-administered questionnaire sent by fax to 26 institutes pertaining to the International Network of Agencies for Health Technology Assessment. RESULTS: None of the countries surveyed had a formal national screening policy. Despite that, all the countries answering the questionnaire had discretionary, public-financed screening practices. Moreover, some scientific and professional organizations recommended population screening for prostate cancer, and few of the surveyed countries offered it as experimental practice within a randomized controlled trial. Survey results showed variation regarding screening policies, in particular test of choice, age cut-off points, and treatment prescribed for positive test results. CONCLUSIONS: Despite the lack of conclusive evidence on the benefits of prostate cancer screening, the availability of simple and easy-to-administer tests has lead to an enormous variation on screening policies around the world. Practice variations also affect prostate cancer therapy.

Could we measure the efficiency of prostate cancer treatment? A critical appraisal of economic evaluation studies.

The objective of this paper is to introduce the methodology of economic analysis in health care, and its application to the measurement of the efficiency analysis of prostate cancer treatment. We presented the methodology of economic analysis. To review its application in prostate cancer treatment, we performed a bibliographic search in the main biomedical databases (February 1988-January 2001) to identify economic evaluation studies that compared both costs and effects of prostate cancer treatments. The lack of economic studies for localized prostate cancer and the diversity of treatments for advanced prostate cancer make it difficult to make comparisons across studies and to make therapeutic recommendations.Prostate Cancer and Prostatic Diseases (2001) 4, 217-220.

Economic analysis of treatment of functional dyspepsia. An assessment of the quality of published studies.

OBJECTIVES: The objective of this study was to assess the quality of economic analysis studies published in the medical and economical literature assessing the clinical management of functional dyspepsia. METHODS: Bibliographic search in the main biomedical databases, in articles from bibliographic references, health technology assessment reports, and in gray literature. A specific protocol with economic and clinical items was designed for the evaluation. RESULTS: Overall, 18 of 162 studies met the inclusion criteria for the assessment. The compared treatment options were very diverse. The main methodologic deficiencies were in perspective of analysis, inclusion of indirect costs, and sources of clinical information. CONCLUSIONS: Specific checklists with clinical and economical items may help to better assess the quality of economic analysis in the field of functional dyspepsia. The methodologic rigor in the application of economic analysis techniques, as well as the use of appropriate clinical outcome measures, is essential to guarantee the reproducibility of the studies.