It is becoming widely accepted that research which considers only the outco
me and not the costs associated with mew technologies in health care, is of
limited value in malting decisions about the use of scarce resources. Econ
omic evaluation is becoming a standard feature of clinical research but man
y published economic evaluations fall short of best practice in their metho
dology. We have described the essential Features of economic evaluation, us
ing published studies in orthopaedics, in order to try to improve the abili
ty of orthopaedic surgeons to read, understand and appraise such studies cr
itically, and to encourage them to consider including economic evaluation i
n future investigations.