The primary source of effectiveness data used in the models was clinical expert opinion, which was obtained through Delphi panel research conducted in a number of European countries as part of the cost-effectiveness assessment of BUCCOLAM.
The following three studies [ 5- 7] used the same source of effectiveness evidence.
The two other studies were modeling studies [ 49, 78] where reviews were used as the source of effectiveness estimates.
The type of analysis (within trial or model based), the setting and the source of effectiveness data were extracted for cost-effectiveness studies.
Particular attention was given to maintaining consistency of the information on resource use with that described in the articles selected as source of effectiveness for the interventions.
Time to wound healing has been used as the endpoint in previous clinical trials of debridement, including the main source of effectiveness used in the sponsor's analysis for hydrogel and larvae [ 33].
Observational studies, particularly those using large administrative claims databases, have become increasingly popular sources of comparative effectiveness or comparative safety research.
A limitation of the economic analysis was the narrow clinical evidence base: the source trial of effectiveness data (Mawhood and Howlin, 1999) had a small sample size (N = 50); moreover, its quasi-experimental design may have introduced bias in the analysis due to confounding factors (Morgan et al., 2000).
These data offer a potentially valuable source of comparative effectiveness evidence on the effectiveness of various forms of CDS that are actually used in clinical practice and may be helpful in rapidly advancing understanding of what forms of CDS do and do not work.
An overview of the sources for effectiveness data used in the evaluations is given in table S5 [see Additional file 5].
