Economic evaluations alongside clinical trials

Our health economists have expertise in conducting economic evaluations alongside clinical trials (EEACTs), and undertaking this work represents a major work programme within HEDS. Most often this is alongside trials managed by the Clinical Trials Unit based within ScHARR. However, we also work alongside researchers conducting trials in other centres around the country.

We have an EEACT working group which seeks to address methodological issues that arise when undertaking economic evaluations alongside clinical trials. Issues that regularly arise when undertaking trial-based evaluations include:

• Missing data and imputation methods;
• Adjustment for between-group differences in baseline characteristics;
• Collecting relevant resource use data;
• Accurately estimating cost implications of new services

The EEACT working group are studying the methodological literature in these and other areas with the aim of drawing up standardised methodological process guides that will ensure consistency between trial-based evaluations – an area where we feel methodological consistency is currently lacking.

HEDS health economists provide expert advice to help researchers to develop and design high quality research proposals via the NIHR Research Design Service for Yorkshire and the Humber, and are also represented on NIHR Research for Patient Benefit Regional Advisory Committees, the NIHR Service Delivery and Organisation Commissioning Board, the NIHR Programme Grants for Applied Research Sub Panel, and several Trial Steering Groups. We are therefore well placed to understand the requirements of funders for the economic evaluation aspect of clinical trials.

Recently completed work includes:

A pragmatic exercise intervention (EXIMS) for people with multiple sclerosis (Lead economist, Jon Tosh)
Community versus hospital pulmonary rehabilitation for chronic obstructive pulmonary disease followed by telephone or conventional follow-up (Lead economist, Katherine Stevens)
Self-managed computer therapy for people with aphasia (Lead economist, Nick Latimer)
A shock-absorbing floor intervention to prevent injuries from falls in hospital wards for older people (Lead economist, Nick Latimer)
Salicylic acid plasters compared with ‘usual’ scalpel debridement of corns: a randomised controlled trial (Lead economist, Simon Dixon)
Introduction of paramedic practitioners for older people in the ambulance service (Lead economist, Simon Dixon)
• ‘Booster’ interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods (Lead economist, Jon Minton)

Ongoing work includes:

• A multi-centre, cluster randomised controlled trial comparing structured education (the KICk-OFF course) with standard care in 11-16 year olds with Type 1 Diabetes (T1DM) on intensive insulin therapy (Lead economist, Hasan Basarir)
• Evaluating the effect of educational needs assessment tool (ENAT) focused education on health outcomes in recently diagnosed rheumatoid arthritis patients (Lead economist, Tracey Young)
• Economic evaluation of a self-administered behavioural intervention following stroke (Lead economist, Tracey Young)
• Obesity Reduction in South Yorkshire: a Randomised Controlled Trial of Services for Obese Adults (Lead economist, Tracey Young)
• Insulin pumps in type 1 diabetes (Lead economist, Simon Dixon)
• Hypertonic saline for infants with acute bronchitis (Lead economist, Simon Dixon)
• Self-managed computer therapy for people with aphasia – full RCT in follow-up to previous pilot study (Lead economist, Nick Latimer)