Issues of consensus and debate for economic evaluation in rheumatology

We report initial attempts at developing standards for the conduct of econo mic evaluations in rheumatology. We surveyed 25 clinicians and economists w ith an interest in rheumatology regarding the design and reporting of econo mic evaluations, with particular reference to 4 clinical scenarios relating to treatment for rheumatoid arthritis, osteoarthritis, and osteoporosis. T he results demonstrated widespread agreement on a number of methodological issues such as statement of funding source, perspective, discounting, and a llowance for uncertainty. However, there was lack of consensus over clinica l variables including sources of data for efficacy estimates, specific clin ical outcomes, methods of assessing quality of life,and choice of comparato rs. Some of the disagreement reflects lack of consensus in current general methodological guidelines, Consensus regarding the disease-specific clinica l variables is crucial to standardizing analysis and facilitating compariso ns within clinical scenarios.