A systematic review of health economic evaluations in orthotics and prosthetics: Part 1-prosthetics

Background: The extent to which current prosthetic health economic evaluations inform healthcare policy and investment decisions is unclear. To further the knowledge in this area, existing evidence gaps and method design issues must be identified, thereby informing the design of future research. Objectives: The aim of this systematic review was to identify evidence gaps, critical method design and reporting issues and determine the extent to which the literature informs a wide range of policy and investment decisions. Study Design: Systematic review. Methods: A range of databases were searched using intervention- and health economic evaluation-related terms. Issues with methodological design and reporting were evaluated using theConsolidated Health Economic Checklist - Extendedand theChecklist for Health Economic Evaluation Reporting Standards. Results: The existing health economic evaluation literature was narrowly focused on informing within-participant component decisions. There were common method design (e.g. time horizon too short) and reporting issues (e.g. competing intervention descriptions) that limit the extent to which this literature can inform policy and investment decisions. Conclusion: There are opportunities to conduct a wider variety of health economic evaluations to support within- and across-sector policy and investment decisions. Changes to aspects of the method design and reporting are encouraged for future research in order to improve the rigour of the health economic evaluation evidence.