Evidence-based medicine and health economics: A case study of end stage renal disease

This paper explores the potential for use of an economic evaluation framewo rk alongside systematic reviews. Clinical issues in dialysis therapy for en d stage renal disease are used as case studies. The effectiveness data requ ired were obtained from a systematic review of randomized controlled trials . Resource use and cost data were obtained from three sources; the identifi ed randomized controlled trials, a separate review of observational studies and primary data collection. The results of the case studies show that, al though simple economic evaluations were possible, issues arose, such as how transferable results are between settings and how appropriate it is to foc us on the average patient. The interface between economic evaluation and sy stematic reviews needs to be further developed in order to ensure that the best available evidence can be used to inform future policy and research. C opyright (C) 2000 John Wiley & Sons, Ltd.