Adherence of Economic Evaluations of Interventions for Retinal Conditions to CHEERS Guidelines: A Systematic Review and Critical Appraisal

PURPOSE: There have been rapid advancements in treatment of retinal disease, with the recent development of novel therapies for many common conditions. Economic evaluation studies are used to examine the implications of implementing health interventions. The objectives of this review were to (1) assess the reporting quality of economic evaluations on retina-related conditions, and (2) evaluate the risk of bias of identified studies, given the implications of bias on study critical appraisal. STUDY DESIGN: Systematic review. METHODS: A literature search was conducted using MEDLINE and Embase (OvidSP) and Cochrane (Wiley) to identify relevant studies published between January 1, 2013 and December 17, 2024. Reporting quality was appraised using the 2022 CHEERS checklist and converted to numerical scores to facilitate data analysis. The JBI Critical Appraisal Checklist for Economic Evaluations was used to assess risk of bias. RESULTS: A total of 174 studies were included. The average CHEERS checklist compliance was 63%, with no trend of improvement or decline in reporting quality over time. Studies most often failed to report the health economic analysis plan (only 5% of studies reported), effect of and approach to engagement with patients and stakeholders (4% and 11% respectively), distributional effects (6%), and characterization of heterogeneity (33%). Only 5% of studies had a publicly available model. CONCLUSIONS: Gaps exist in reporting population heterogeneity, participation of patient and public stakeholders, and fully transparent study methodology in vitreoretinal ophthalmology economic evaluations. Ophthalmology health economics researchers should consider including these details to ameliorate interpretation and application of study findings.