Table 2

Summary presentation of the methodological qualities of selected studies

PaperGood methodological quality of AE identificationAppropriate tradeoffs between level of detail and scale of the project in economic estimationGood methodological quality of cost estimationsDetailed description of cost estimation methodsPresentation of cost–benefit ratioSensitivity analysis
Eber et al (2010)32Yes, the usage of administrative data was a good option, given the high specificity and positive predictive values of identification of the AEs considered in the recordsYes, cost-to-tariff conversion was appropriate for a gross estimation of nationwide burden of diseaseYes, good criteria were used for matched comparisonYesNot applicableOne-way sensitivity analyses were done
Dietrich et al (2002)31Yes, in the prospective series, the usage of validated clinical criteria allows for reliable identification of AEsYes, the relatively small sample allowed for detailed micro-costing and analysisYes, good example of differences in prospective and retrospective analysesYesNot applicableLacking
Sheng et al (2005)41Yes, AEs were identified following validated CDC criteria applied to different infection sitesYes, micro-costing collection from financial services was appropriate considering the sample sizeYes, good criteria were used for matched comparisonYes, in particular, the matched comparison analysis is fully describedNot applicableLacking
Fukuda et al (2008)26Not applicableYes, the results of a pilot study (Fukuda et al25) allowed identification of the costs to be includedYes, a standardised questionnaire was used for collection throughout HCOsYesNot applicableLacking
Stone et al (2007)45Not applicableNo, data collection unduly complete considering the sample sizeYes, cost valuations were standardised for 100 beds, which allowed for comparisonsYesNot applicableLacking
Brown and Lilford (2009)48No, only published estimates are used in the modelYesYes, although relying on hypotheses and assumptions that are difficult to proveYesYes, the net cost is presentedYes
Calugar et al (2006)46Yes, based on clinical and biological diagnosis for cases and usual contact identification and screening techniquesYes, detailed information on a single outbreak was collected and combined to literature data, which allows for avoiding resource intensive estimationsYes, costs are estimated conservatively, but results are compared with other similar studiesYes, clear and fully describedYes, the cost–effectiveness ratio is presentedOne-way sensitivity analyses were done
Karnon et al (2008)55Not applicable (identification technique referenced to another report)Yes, multiple sources of published data were used and empirical dataYes, interesting example of usage of decision analytic models for estimating potential benefits of a specific safety practiceYes, the hypotheses underlying the model are clearly exposedYes, the net benefit is presentedLacking
Van Rijen and Kluytmans (2009)49Yes, based on laboratory data and following systematic screening of ‘suspected’ or ‘at risk’ casesYes, very detailed collection was appropriate for the HCO settingYes, although it would have been useful to discount values because of the large collection spanYesYes, the cost–effectiveness ratio is presentedLacking
Wang et al (2003)28No, multiple sources are used and the criteria for defining AEs were not clearly statedYesYes, very good example of stochastic modelling, with both empirical and literature dataYesYes, the net benefit is presentedYes, both one-way and five-way sensitive analyses were performed

  • AE, adverse event; CDC, Centers for Disease Control; HCO, healthcare organisation.