Limitation of included model-based analyses
| Study . | Does the model structure adequately reflect the nature of the health condition? . | Is the time horizon sufficiently long to reflect all important differences in cost and outcomes? . | Are all important and relevant health outcomes considered? . | Are the clinical inputs obtained from the best available sources? . | Are all important and relevant costs included in the analysis? . | Are the estimates and unit costs of resource use obtained from best available sources? . | Is an appropriate incremental analysis presented or can it be calculated? . | Are all important and uncertain parameters subjected to appropriate analysis? . | Is there a potential conflict of interest? . | Overall judgment . |
|---|---|---|---|---|---|---|---|---|---|---|
| DVT | ||||||||||
| Duriseti 2010 | Probably yes | Yes (25 y) | Yes | Probably yes (literature review) | Yes | Probably yes | No (conducted but not reported) | Yes | Probably no (governmental/public funding) | Potentially serious limitation |
| Goodacre 2006 | Probably yes | Yes (lifetime horizon) | Yes | Yes (systematic review and meta-analysis) | Yes | Probably yes | Yes | Yes | Probably no (governmental/public funding) | Minor limitation |
| Hedderich 2019 | Probably yes | Yes (lifetime horizon) | Yes | Probably yes (literature) | Yes | Probably yes | Yes | Yes | Probably no (no funding) | Minor limitation |
| Hendriksen 2015 | Probably yes | Probably yes (10 y) | Probably yes | Yes (Systematic review and meta-analysis) | Yes | Probably yes | Yes | Yes | Probably no (governmental/public funding) | Minor limitation |
| Hillner 1992 | Probably yes | Probably no (3 mo) | Probably yes | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Kim 2000 | Probably yes | Yes (lifetime horizon) | Yes | Yes (systematic review and meta-analysis) | Yes | Probably yes | Yes | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Norlin 2010 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (prospective cohort) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| Novielli 2013 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Yes (systematic review and meta-analysis) | Unclear | Unclear | No (conducted but not reported) | Yes | Probably no (governmental/public funding) | Potential serious limitation |
| Paterson 2001 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Perone 2001 | Probably yes | Probably no (3 mo) | Yes | Probably yes (literature) | Yes | Probably yes | Yes | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Van Dam 2021 | Probably yes | Probably no (1 y) | Yes | Probably yes (prospective cohort and literature) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Probably no (industry-funded project, declaring no conflict interest) | Potential serious limitation |
| Wilson 2005 | Probably yes | Probably yes (4 y, life expectancy of those with ischemic stroke) | Yes | Probably yes (literature) | Yes | Probably yes | Yes | Probably yes (only deterministic sensitivity analysis) | Probably no (no commercial funding) | Minor limitation |
| PE | ||||||||||
| Batalles 2009 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (literature review) | Yes | Probably yes | Probably yes (cost per additional PE diagnosis) | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| Blondon 2020 | Probably yes | Yes (lifetime horizon) | Yes | Probably yes (prospective cohorts) | Yes | Probably yes | Yes | Yes | Probably no (governmental/public funding) | Minor limitation |
| Doyle 2004 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only survival) | Yes (systematic review and meta-analysis) | No (only diagnosis related costs) | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Duriseti 2006 | Probably yes | Yes (25 y) | Yes | Probably yes (literature review) | Yes | Probably yes | No (conducted but not reported) | Yes | Probably no (governmental/public funding) | Potential serious limitation |
| Elias 2004 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Goodacre 2018 | Probably yes | Yes (Lifetime horizon) | Yes | Yes (systematic review and meta-analysis) | Yes | Probably yes | Yes | Yes | Probably no (governmental/public funding) | Minor limitation |
| Henschke 1997 | Probably yes | Probably no (6 mo) | Probably yes | Probably yes (literature) | Yes | Probably yes | No | No | Unclear | Potential serious limitation |
| Hull 1996 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (prospective cohort) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Hull 2001 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (prospective cohort) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Humphreys 2004 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (literature) | No (only diagnosis-related costs) | Probably yes | No | Yes | Unclear | Potential serious limitation |
| Larcos 2000 | Probably yes | Yes (lifetime horizon) | Probably no (only survival) | Probably yes (retrospective review of cases) | Yes | Probably yes | Probably yes (cost per life-year gained) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Lee 2011 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| Michel 1996 | Probably yes | Probably no (6 mo) | Yes | Probably yes (prospective cohort) | Yes | Probably yes | Yes | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Oudkerk 1993 | Probably yes | Probably no (3 mo) | Probably no (only diagnostic performance) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Perrier 1997 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Perrier 2003 | Probably yes | Probably no (3 mo) | Yes | Probably yes (literature review) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Righini 2007 | Probably yes | Probably no (3 mo) | Yes | Probably yes (2 recent outcome studies) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Toney 2017 | Probably yes | Probably no (30 d) | Probably no (only survival) | Yes (systematic review and meta-analysis) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| Van Beek 1996 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (data on 179 patients) | Yes | Unclear | No | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| Van Erkel 1996 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Van Erkel 1998 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Van Erkel 1999 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Yes (systematic review and meta-analysis) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Ward 2011 | Probably yes | Probably no (6 mo) | Yes | Probably yes (Literature) | Yes | Probably yes | Yes | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| PE and DVT | ||||||||||
| Henschke 1994 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (literature) | No (only diagnosis related costs) | Probably yes | No | No | Unclear | Potential serious limitation |
| Study . | Does the model structure adequately reflect the nature of the health condition? . | Is the time horizon sufficiently long to reflect all important differences in cost and outcomes? . | Are all important and relevant health outcomes considered? . | Are the clinical inputs obtained from the best available sources? . | Are all important and relevant costs included in the analysis? . | Are the estimates and unit costs of resource use obtained from best available sources? . | Is an appropriate incremental analysis presented or can it be calculated? . | Are all important and uncertain parameters subjected to appropriate analysis? . | Is there a potential conflict of interest? . | Overall judgment . |
|---|---|---|---|---|---|---|---|---|---|---|
| DVT | ||||||||||
| Duriseti 2010 | Probably yes | Yes (25 y) | Yes | Probably yes (literature review) | Yes | Probably yes | No (conducted but not reported) | Yes | Probably no (governmental/public funding) | Potentially serious limitation |
| Goodacre 2006 | Probably yes | Yes (lifetime horizon) | Yes | Yes (systematic review and meta-analysis) | Yes | Probably yes | Yes | Yes | Probably no (governmental/public funding) | Minor limitation |
| Hedderich 2019 | Probably yes | Yes (lifetime horizon) | Yes | Probably yes (literature) | Yes | Probably yes | Yes | Yes | Probably no (no funding) | Minor limitation |
| Hendriksen 2015 | Probably yes | Probably yes (10 y) | Probably yes | Yes (Systematic review and meta-analysis) | Yes | Probably yes | Yes | Yes | Probably no (governmental/public funding) | Minor limitation |
| Hillner 1992 | Probably yes | Probably no (3 mo) | Probably yes | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Kim 2000 | Probably yes | Yes (lifetime horizon) | Yes | Yes (systematic review and meta-analysis) | Yes | Probably yes | Yes | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Norlin 2010 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (prospective cohort) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| Novielli 2013 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Yes (systematic review and meta-analysis) | Unclear | Unclear | No (conducted but not reported) | Yes | Probably no (governmental/public funding) | Potential serious limitation |
| Paterson 2001 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Perone 2001 | Probably yes | Probably no (3 mo) | Yes | Probably yes (literature) | Yes | Probably yes | Yes | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Van Dam 2021 | Probably yes | Probably no (1 y) | Yes | Probably yes (prospective cohort and literature) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Probably no (industry-funded project, declaring no conflict interest) | Potential serious limitation |
| Wilson 2005 | Probably yes | Probably yes (4 y, life expectancy of those with ischemic stroke) | Yes | Probably yes (literature) | Yes | Probably yes | Yes | Probably yes (only deterministic sensitivity analysis) | Probably no (no commercial funding) | Minor limitation |
| PE | ||||||||||
| Batalles 2009 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (literature review) | Yes | Probably yes | Probably yes (cost per additional PE diagnosis) | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| Blondon 2020 | Probably yes | Yes (lifetime horizon) | Yes | Probably yes (prospective cohorts) | Yes | Probably yes | Yes | Yes | Probably no (governmental/public funding) | Minor limitation |
| Doyle 2004 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only survival) | Yes (systematic review and meta-analysis) | No (only diagnosis related costs) | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Duriseti 2006 | Probably yes | Yes (25 y) | Yes | Probably yes (literature review) | Yes | Probably yes | No (conducted but not reported) | Yes | Probably no (governmental/public funding) | Potential serious limitation |
| Elias 2004 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Goodacre 2018 | Probably yes | Yes (Lifetime horizon) | Yes | Yes (systematic review and meta-analysis) | Yes | Probably yes | Yes | Yes | Probably no (governmental/public funding) | Minor limitation |
| Henschke 1997 | Probably yes | Probably no (6 mo) | Probably yes | Probably yes (literature) | Yes | Probably yes | No | No | Unclear | Potential serious limitation |
| Hull 1996 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (prospective cohort) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Hull 2001 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (prospective cohort) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Humphreys 2004 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (literature) | No (only diagnosis-related costs) | Probably yes | No | Yes | Unclear | Potential serious limitation |
| Larcos 2000 | Probably yes | Yes (lifetime horizon) | Probably no (only survival) | Probably yes (retrospective review of cases) | Yes | Probably yes | Probably yes (cost per life-year gained) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Lee 2011 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| Michel 1996 | Probably yes | Probably no (6 mo) | Yes | Probably yes (prospective cohort) | Yes | Probably yes | Yes | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Oudkerk 1993 | Probably yes | Probably no (3 mo) | Probably no (only diagnostic performance) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Perrier 1997 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Perrier 2003 | Probably yes | Probably no (3 mo) | Yes | Probably yes (literature review) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Righini 2007 | Probably yes | Probably no (3 mo) | Yes | Probably yes (2 recent outcome studies) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Toney 2017 | Probably yes | Probably no (30 d) | Probably no (only survival) | Yes (systematic review and meta-analysis) | Yes | Probably yes | No | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| Van Beek 1996 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (data on 179 patients) | Yes | Unclear | No | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| Van Erkel 1996 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Van Erkel 1998 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Probably yes (literature) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Unclear | Potential serious limitation |
| Van Erkel 1999 | Probably yes | Probably no (3 mo) | Probably no (only survival) | Yes (systematic review and meta-analysis) | Yes | Probably yes | Probably yes (cost per life saved) | Probably yes (only deterministic sensitivity analysis) | Probably no (governmental/public funding) | Potential serious limitation |
| Ward 2011 | Probably yes | Probably no (6 mo) | Yes | Probably yes (Literature) | Yes | Probably yes | Yes | Probably yes (only deterministic sensitivity analysis) | Probably no (declaring no conflict interest) | Potential serious limitation |
| PE and DVT | ||||||||||
| Henschke 1994 | Probably yes | Probably no (likely a short temporal horizon) | Probably no (only diagnostic performance) | Probably yes (literature) | No (only diagnosis related costs) | Probably yes | No | No | Unclear | Potential serious limitation |