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Published Online: 27 June 2014

Critical Appraisal of Published Systematic Reviews Assessing the Cost-Effectiveness of Telemedicine Studies

Publication: Telemedicine and e-Health
Volume 20, Issue Number 7


Background: Over the last 10 years several systematic reviews have been published on the cost-effectiveness of telemedicine studies. Most reviews have concluded that there is not much difference in the cost-effectiveness when delivering health services via telemedicine or by conventional means. We are not aware of any systematic review looking at the systematic reviews of cost-effectiveness of telemedicine. This study was designed to identify published systematic reviews on the cost-effectiveness of telemedicine studies and to undertake a quality assessment of the identified systematic reviews. Materials and Methods: We searched six electronic databases, including Medline, Embase, and the NHS Economic Evaluation Database, combining “review” terms with “telemedicine” terms to identify systematic reviews. Results: We identified 4,116 potential abstracts. Nine systematic reviews met the inclusion criteria, which looked at the cost-effectiveness of telemedicine in general. All reviews were similar in terms of their stated purpose, and the objectives were clear. Three of the reviews did not use a checklist for the economic evaluation studies included in their review. The quality assessment found that five of the nine reviews had minimal flaws. Conclusions: Even though the general quality of reporting of the reviews was fine, we have found that conclusions cannot be drawn on the cost-effectiveness of telemedicine applications based on the methodological flaws in the economic analysis of the studies included in the reviews. Over time, reporting of cost-effectiveness has generally improved; however, there is still room for improvement, and authors need to use the recommended checklists for economic evaluations.

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Published In

cover image Telemedicine and e-Health
Telemedicine and e-Health
Volume 20Issue Number 7July 2014
Pages: 609 - 618
PubMed: 24820406


Published in print: July 2014
Published online: 27 June 2014
Published ahead of print: 12 May 2014
Accepted: 22 October 2013
Revision received: 22 October 2013
Received: 29 July 2013


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Hema Mistry, PhD
Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Health Economics Unit, University of Birmingham, Birmingham, United Kingdom.
Hyeladzira Garnvwa, MSc
Health Economics Unit, University of Birmingham, Birmingham, United Kingdom.
Raymond Oppong, MSc
Health Economics Unit, University of Birmingham, Birmingham, United Kingdom.


Address correspondence to:Hema Mistry, PhDWarwick EvidenceWarwick Medical SchoolUniversity of WarwickGibbet Hill RoadCoventry, CV4 7ALUnited Kingdom
E-mail: [email protected]

Disclosure Statement

No competing financial interests exist.

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