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Fischer: "High-quality research providing robust evidence is vital to ensure best possible care"

Updated: May 26, 2020

One of the centers taking part in our research, the Medical University of Vienna, is conducting research on economic aspects of health care interventions. The protocol of their systematic review, 'Methodological aspects of economic evaluations conducted in the palliative or end of life care settings: a systematic review protocol', has been recently accepted for publication by BMJ Open.

We talk with scientist Claudia Fischer about their research, and how it is related with the iLIVE Project.

What is your role in this project?

The Medical University of Vienna (MUW) leads Work package 4 of the iLIVE project. This work package focusses on the economic evaluation of the interventions performed in the course of the iLIVE project.

How will this work impact the development of iLIVE Project?

To ensure that the economic evaluation of an intervention can generate useful evidence and serve as decision base, they need to fulfill a high methodological standard. The palliative and end-of-life care settings vary from other health care fields, in which economic evaluations are well established. Therefore, it is debated whether general economic evaluation guidelines are fully applicable to the palliative and end-of-life care settings. The systematic review that is conducted in the course of the iLIVE project aims to identify methodological aspects and challenges of conducting economic evaluations especially in palliative and end-of-life care. It is aimed to synthesize recommendations and potential solutions to overcome identified challenges, to identify unresolved methodological challenges, and to develop a methodological framework guideline for economic evaluations in the palliative and end-of-life care settings. Relevant lessons learned will be fully incorporated in the design of the iLIVE intervention studies.

Economic evaluations are usually not in the spotlight. Why is it important to shed light on this matter?

Economic evaluations, so evaluating outcomes and costs of an intervention, are especially challenging when trying to evaluate complex interventions, such as those in the palliative and end of life care settings. The knowledge about the range, extent of costs associated with the provision of palliative and end-of-life care, and how to measure those, is limited. Broader, non-clinical outcomes are often not considered in economic evaluations in this field, which may be related to difficulties concerning recruitment and measurement in this very vulnerable patient group and often leads to underestimation of potential benefits. With the increase of the ageing population living with advanced stages of incurable chronic conditions near the end of life and the associated rise in palliative and end-of-life care needs, while facing scare resources, high-quality research providing robust evidence is vital to ensure best possible care and form a valid base for decision making.

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