Quality assessment

The methodological quality of HIV testing economic evaluations was assessed using two tools: Drummond’s ten-point criteria for economic evaluations and the 24-item Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist [37–39]. For both lists, each item was scored as ‘Yes’ (met the quality criterion), or ‘No’ (did not meet the quality criterion), or ‘Can’t tell’ where there was insufficient evidence to make a decision. A numeric score was not calculated for each study.

For the CHEERS criteria, the “Yes” responses were weighed against the total number of criteria for a percentage. This approach has been used in recently published systematic reviews of economic evaluations [40–43].

The two checklists used had slightly different focus but were nonetheless complimentary. While the Drummond checklist assesses appropriate methodology in the economic evaluation and evaluates the results’ validity, the CHEERS checklist focuses on reporting issues. Using the CHEERS checklist, studies were assessed into three categories: high if they satisfied greater than 75% of the criteria, average (50–75%) and low quality when less than 50% of the criteria was satisfied.