Page 71 - DECISION-MAKING IN SEVERE TRAUMATIC BRAIN INJURY PATIENT OUTCOME, HOSPITAL COSTS, AND RESEARCH PRACTICE

Review on in-hospital costs after severe traumatic brain injury
Article selection and data extraction
First, duplicates, non-English and unretrievable records were excluded. Second, two
reviewers (JD,MD) independently screened the titles and abstracts of the remaining
studies and selected all potential eligible studies. Full-texts were independently
reviewed by the same researchers and studies were included according to the above
mentioned criteria. During the process, all disagreements were resolved through 3 discussion until consensus or after consulting a third researcher (RO). Data extraction
was performed in duplicate using pre-created data extraction sheets. Extracted data was then discussed and combined. Variables that were collected included: study details, study population, definition of TBI (including severity), healthcare consumption, details of costs research methodology and cost outcome results.
Quality assessment
A 19-item checklist was used to assure an accurate quality assessment for the evaluation of in-hospital costs following s-TBI. The checklist was based on the CHEERS statement, which is developed to improve the reporting on economic evaluations. 27-30 We slightly adjusted the items from the CHEERS statement by specifying items like ‘target population and subgroups’ in clear definition of illness and TBI severity, because this was deemed necessary for proper interpretation of study results. Also we intentionally left out items like cost perspective, time horizon and discounting costs since these were considered not relevant for short term in-hospital costs. The final checklist covers items in the areas of study details, population, clinical data, cost data and study methodology. All relevant details can be found in S2 Appendix.
The quality assessment was independently performed by three reviewers (JD, MD, RO). Disagreements were reassessed and discussed in several meetings until consensus was reached. All items were scored according to a predefined scoring manual that included four options: yes (1), suboptimal (0.5), no (0) and not applicable (N/A). A double weight was assigned to several items that were considered to be particularly important in calculating and reporting in-hospital costs. Final scores represented study quality and were presented as a percentage of the maximum score per study. Scores per item and item category were also calculated. All items that were not applicable were excluded from score calculation. When studies used a statistical model, items were scored considering the clear use and description of the model input parameters and sources.
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