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General information
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Review ID
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Author, year
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Title
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Reviewer
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Date of review
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Publication type
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Population and setting
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Type of study
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Stated type of economic analysis
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Actual type of economic analysis (if different)
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Country of study
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Study setting
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Population
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Study size
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Method of recruitment
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Recruitment time period
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Inclusion criteria
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Exclusion criteria
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Study design
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Primary intervention
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Secondary intervention(s)
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Comparators
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Time horizon (for follow-up)
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Outcomes
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Outcomes measure (1)
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Method of measurement (1)
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Outcome measure (2)
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Method of measurement (2)
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Outcome measure (3)
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Method of measurement (3)
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Secondary outcome measure(s)
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Method of measurement(s)
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For utility studies: what value set or direct method of measurement has been used?
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Timing of measurements
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Discount rate, outcomes
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Method of dealing with missing data—outcomes
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Resource and cost information
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Cost perspective
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Intervention costs
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Direct cost items
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Method of capturing direct cost items
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Direct cost data sources
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Indirect cost items
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Method of capturing indirect cost items
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Indirect cost data sources
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Resource items collected
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Resource use, recall period
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Method of dealing with missing data—cost
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Price year
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Currency
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Inflation rate, cost
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Discount rate, cost
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Results
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Resource use and costs
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Outcomes
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Reported cost effectiveness
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Appropriateness of ICER
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Sensitivity analysis
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Major result(s)
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Conclusions
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Funding source
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Model specific information
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Type of decision analytic model
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Model perspective
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Model population
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Cohort or individual?
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Model assumptions
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Model exclusions
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Method for dividing disease severity
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Distinction between body/face eczema?
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Interventions included
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Time horizon
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Cycle length
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Value of any parameters used
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Source of parameters
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Software used for model
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Type of sensitivity analysis performed
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Method of model validation
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Author specified limitations
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