Critically analyse a published economic evaluation
by Williams et al (VALUE IN HEALTH. 2020; 23(8):1003–1011) on the cost-effectiveness of opt-out emergency department-based Hepatitis B (HBV) and Hepatitis C (HCV) testing and linkage to care,
compared to no emergency department testing in the UK.
What are the key data sources used and are they appropriate? [5 marks]
2. Where is the quality of life data elicited from? Patients, experts or the general public and from
what setting. Does the source or type of quality of life data impact the strength of findings or
introduce a bias? [10 marks]
3. Are comparators and outcomes well described? Do the authors explain their modelling
choices, and could a different/ more complex model or type of modelling have been used?
[15 marks]
4. Around which variables is there most uncertainty and what does the probabilistic sensitivity analysis say about the overall uncertainty surrounding the results? What are the implications of this uncertainty for study findings? [15 marks]
5. How is discounting used? How would changes in the discount rate impact results if there is no sensitivity analysis around discount rates? [5 marks]
6. Based on this study would you recommend that emergency department testing and linkage to care for HCV and HBV be introduced in the management HBV and HCV in the UK? [10
marks]
7. What additional information would you want to have apart from this study to make a
recommendation? [5 marks]
8. What are the directions for future research coming out of this study? (any mentioned by the
authors, but also gaps you see) [5 marks]
9. What is the external validity of this study and what factors might be considered by other
countries looking to interpret and use these results [10 marks]
