Diagnosing Alzheimer's disease: a systematic review of economic evaluations

Abstract

Background: The objective of this study is to systematically review the literature on economic evaluations of interventions for the early diagnosis of Alzheimer's disease (AD) and related disorders and to describe their general and methodological characteristics. We focused on the diagnostic aspects of the decision models to assess the applicability of existing decision models for the evaluation of the recently revised diagnostic research criteria for AD.

Methods: PubMed and the National Institute for Health Research Economic Evaluation database were searched for English-language publications related to economic evaluations on diagnostic technologies. Trial-based economic evaluations were assessed using the Consensus on Health Economic Criteria list. Modeling studies were assessed using the framework for quality assessment of decision-analytic models.

Results: The search retrieved 2109 items, from which eight decision-analytic modeling studies and one trial-based economic evaluation met all eligibility criteria.

Conclusions: Diversity among the study objective and characteristics was considerable and, despite considerable methodological quality, several flaws were indicated. Recommendations were focused on diagnostic aspects and the applicability of existing models for the evaluation of recently revised diagnostic research criteria for AD.

Keywords: Alzheimer's disease; Biomarker; Cost-effectiveness; Costs; Decision-analytic model; Dementia; Diagnostic intervention; Early diagnosis; Economic evaluation; Health technology assessment; Modeling; Neurodegenerative disorder; Quality assessment; Review.