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Table 2 The PICOT Framework, with extensions helpful to interpreting the findings of economic evaluations

From: Economic evaluation: a reader’s guide to studies of cost-effectiveness

Population

Are the patients studied like the patients I see?

Are the results reported on the basis of per-person treated, per-capita (of the whole population), per x,000 people, for a whole national/state population, …?

Intervention

The same meaning as in the interpretation of a RCT

Comparison

Is the comparison genuinely a real-world alternative (i.e. what a typical patient in the study setting would otherwise get)? If not, it is difficult for a health service decision-maker to interpret what the results mean.

Outcome

Costs: What is the perspective for counting the costs? Is it strictly the payer; the whole health system; are all health costs counted or just ones directly attributable to the disease/condition; does it include costs borne by the patient; does it include wider societal costs, such as welfare benefit payments and productivity? How wide is the net cast?

What is the ‘effects’ outcome (e.g. QALYs, deaths, responders, units of an OM? Be aware of what form are the results presented, so you can make sense of the numbers.

Timeframe

How long after intervention are the costs and effects being measured? This is known as the time horizon. The longer the time horizon, the greater the time available to accrue possible costs and effects.

  1. Notes: PICOT Population Intervention Comparison Outcome, and Timeframe, RCT randomized clinical trial, QALYs quality-adjusted life-years, OM = outcome measure