In Reply: Although we agree with Dr Gandjour
that our review found a disappointing variable general quality of economic
evaluations, his suggestions would have had little effect on our conclusions,
since our primary focus was the methods used in the systematic reviews of
economic evaluations, not the economic evaluations per se. Most of the instruments
used in the reviews that we assessed did not include detailed consideration
of methods of data aggregation, such as bootstrapping or Monte Carlo simulation,
as these techniques have only been more commonly used in the last 4 years
or so. However, some instruments, such as the BMJ
checklist,1 do include a question on details
of models used in the economic evaluation and on methods used to create parameters
in the models used. In addition, the only review specifically assessing methods
to handle uncertainty in economic evaluations, that by Briggs and Gray,2 showed that sensitivity analysis has rarely been
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