Importance of health economics must be recognised when trials are designed

BMJ 1999;318:1696 ( 19 June )

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Importance of health economics must be recognised when trials are designed

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EDITOR $---$ Barbert and Thompson's study is welcome if it leads trial designers to recognise health economics as more than a (non-essential)afterthought to their trial.¹ The points that the authors makewould benefit from a more complete understanding of the natureof economic data and the context in which economic analyses areundertaken.²

Clinical outcomes in trials tend to be uni-dimensional and unambiguous (such as survival or response to treatment), whereaseconomic data are essentially multidimensional. Health care embracesthe use of a multitude of resources, each measured in differentunits and attracting its own distinct pricing regime. The economicaspect of a typical clinical trial will require information tobe collected for 20-30 such items, each subject to a differentstatistical distribution. Theoretically, sample size should becalculated for each of these and the trial's recruitment targetdetermined as that of the largest. But this requires knowledgeof the . . . [Full text of this article]

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