QUALITY ASSESSMENT OF ECONOMIC EVALUATIONS IN SELECTED PHARMACY, MEDICAL, AND HEALTH ECONOMICS JOURNALS

OBJECTIVE: To assess and compare the quality of economic studies in se lected pharmacy, medical, and health economics journals. DATA SOURCES: DICP The Annals of Pharmacotherapy, American Journal of Hospital Phar macy, Hospital Pharmacy, New England Journal of Medicine, Medical Care , Journal of the American Medical Association, PharmacoEconomics, Inte rnational Journal of Technology Assessment in Health Care, and Journal of Health Economics using MEDLINE, EMBASE, and International Pharmace utical Abstracts. Search terms included ''economic,'' ''cost,'' and '' cost analysis.'' STUDY SELECTION: Reviewers appraised abstracts to ide ntify original research published during 1989-1993 comparing costs and outcomes between drugs, treatments, and/or services. Initially, 123 a rticles met criteria; 16 were inappropriate, 17 were randomized out, a nd 90 (73%) were used (30/group). DATA EXTRACTION: Quality was assesse d using a 13-item checklist. Interrater reliability was 0.91 (p < 0.05 ) for 9 raters, test-retest reliability was 0.94 (p < 0.001). DATA SYN THESIS: A 2-way ANOVA, with overall quality scores as a dependent vari able with journal type and year as independent variables, was signific ant (F = 2.79, p = 0.002, r(2) = 0.34), with no significant interactio n (F = 0.71, p = 0.68) or time effect (F = 0.70, p = 0.60). Journal ty pes differed; pharmacy journals scored significantly lower (chi(2) = 5 3.89, df = 2, p < 0.001). Items rated adequate (i.e., correct or accep table) increased over time (chi(2) = 21.18, df = 4, p < 0.001). Ethica l issues and study perspective most needed improvement. CONCLUSIONS: A rticle quality for all journal types increased over time nonsignifican tly; health economics journals scored highest, then medical journals, with pharmacy journals significantly lower (and having the highest sta ndard deviation). We recommend that authors and reviewers pay closer a ttention to study perspective and ethical implications.