Unbiasing costs? An appraisal of economic assessment alongside randomized trials in neonatology

Susanne Hay, Meredith Mowitz, Dmitry Dukhovny, Christine Viner, Jonathan Levin, Brian King, John A.F. Zupancic

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Economic evaluations performed alongside randomized controlled trials benefit from the protections against bias inherent in randomization. In this systematic review, we assessed the frequency and quality of economic assessments alongside randomized controlled trials of interventions in neonates published between 1990 and 2016. Over that period, 58 economic assessments were published, corresponding to approximately 2% of RCTs. We noted significant methodological limitations of these studies, including limitation of included costs to the health sector or payer rather than broader categories such as family or community expenditures (81%), short time horizon for cost measurement (less than one year in 60%), lack of reporting of uncertainty (26%), and infrequent analysis of costs and effects in a single metric (combined in 45%). Strategies for improving the quality and frequency of economic evaluations in neonatology are discussed, including selection of appropriate trials, funding, and peer review.

Original languageEnglish (US)
Article number151391
JournalSeminars in Perinatology
Issue number3
StatePublished - Apr 2021


  • Controlled clinical trials
  • Costs and cost analysis
  • Infant
  • Newborn

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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