Intended for healthcare professionals

Education And Debate

Summarising economic evaluations in systematic reviews: a new approach

BMJ 2001; 322 doi: (Published 30 June 2001) Cite this as: BMJ 2001;322:1596
  1. John Nixon, research fellow in health economics (,
  2. Khalid S Khan, visiting research fellow,
  3. Jos Kleijnen, professor
  1. NHS Centre for Reviews and Dissemination, University of York, York YO10 5DD
  1. Correspondence to: J Nixon
  • Accepted 20 February 2001

Systematic reviews of healthcare interventions, which are aimed at informing health policy, increasingly include economic evaluations in addition to evaluations of clinical effectiveness.13 The challenge reviewers face is collating, appraising, and synthesising economic evidence in such a way that it is clearly helpful in making decisions about the effects and costs of competing alternatives. However, the methodology for summarising the findings of economic evaluations is not as well established as that applied to structured summaries of clinical evidence. The aim of this paper is to illustrate and discuss the relative merits of commonly used methods and to offer a new approach that makes interpreting the evidence easier for decision makers who require a clear overview of the findings.

Summary points

Systematic reviews of healthcare interventions are increasingly integrating clinical and economic evidence

Methods are needed to summarise and convey clearly the findings of these reviews

The methodology for summarising the results of economic evaluations is not well established

Methods for summarising the results of economic evaluations include narratives, tables, the cost effectiveness plane, and permutation matrices

A new hierarchical method offers an effective means of summarising the results of economic evaluations within a systematic review

We describe well established methods that can be used to summarise the findings of a review of economic evaluations, namely narrative summaries, permutation matrices, and the cost effectiveness plane, and we give examples of how a permutation matrix has or could have been used in two published systematic reviews. Finally, a new method is described that presents the same information in a clear, concise, and hierarchical manner and which provides an effective tool for summarising the same results.

Existing summary methods

The most elementary method of summarising the results of a review of economic evaluations is the narrative summary, which, in conjunction with a tabular approach to …

View Full Text

Log in

Log in through your institution


* For online subscription