Do Randomized Controlled Trials Discuss Healthcare Costs 英文参考文献.docVIP

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Do Randomized Controlled Trials Discuss Healthcare Costs 英文参考文献.doc

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Do Randomized Controlled Trials Discuss Healthcare Costs 英文参考文献

DoRandomizedControlledTrialsDiscussHealthcare Costs? G.MichaelAllan1,2,3*,ChristinaKorownyk1,KateLaSalle1,BenVandermeer4,VictoriaMa1 ,Douglas Klein1,5,DonnaManca1,6 1DepartmentofFamilyMedicine,UniversityofAlberta,Edmonton,Alberta,Canada,2InstituteofHealthEconomics,Edmonton,Alberta,Canada,3TowardsOptimized Practice,Edmonton,Alberta,Canada,4AlbertaResearchCentreforHealthEvidence,UniversityofAlberta,Edmonton,Alberta,Canada,5ContinuedProfessionalLearning, UniversityofAlberta,Edmonton,Alberta,Canada,6AlbertaFamilyPracticeResearchNetwork,Edmonton,Alberta,Canada Abstract Background:Healthcarecosts,particularlypharmaceuticalcosts,areadominantissueformosthealthcareorganizations, butitisunclearifrandomizedcontrolledtrials(RCTs)routinelydiscusscosts.Ourobjectivewastoassessthefrequencyand factorsassociatedwiththeinclusionofcostsinRCTs. Methods and Findings: Werandomlysampled188RCTsspanningthreeyears(2003-2005)fromsixhighimpactjournals. The sample size for RCTs was based on a calculation to estimate the inclusion of actual drug costs with a precision of +/23%.Tworeviewersindependentlyextractedcostdataandstudycharacteristics.Frequencieswerecalculatedandpotential characteristicsassociatedwiththeinclusionofcostswereexplored.Actualdrugcostswereincludedin4.7%(9/188)ofRCTs; anyactualcostswereincludedin7.4%(14/188)ofRCTs;andanymentionofcostswasincludedin27.7%(52/188)ofRCTs.As theamountofindustryfundingincreasedacrossRCTs,fromnon-profittomixedtofullyindustryfundedRCTs,therewasa statistically significant reduction in the number of RCTs with any actual costs (Cochran-Armitage test, p=0.005) and any mentionofcosts(Cochran-Armitagetest,p=0.02).Logisticregressionanalysisalsoindicatedfundingwasassociatedwiththe inclusionofanyactualcost(OR=0.34,p=0.009)oranymentionofcosts(OR=0.63,p=0.02).Journal,studyconclusions,study location,primaryauthor’scountryandproductagewerenotassociatedwithinclusionofcostinformation. Conclusion:Whilephysiciansareencouragedtoconsidercostswhenprescribingdrugsfortheirp