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The hidden role of values in the evaluation of physiotherapy services (Maude Laliberté, 01 August 2013)

This commentary responds to an article by Dionne and colleagues [1] that, in collaboration with the Canadian Physiotherapy Association, shows how to apply the Multi-Criteria Decision Analysis (MCDA) as a framework to develop accurate estimates of the value of specific physiotherapy interventions. The MCDA is a way to evaluate and weight different conflicting criteria in a decision-making process. At first glance, the MCDA seems to be an objective tool as it includes a multitude of criteria (such as the other health effects, the wider societal effects and the nonmonetary costs) in addition to economic efficiency. Physiotherapy services was evaluated using 11 criteria: resource impact, quality of life, patient and provider satisfaction, integration, access, equity, effectiveness... read full comment

Comment on: Dionne et al. Cost Effectiveness and Resource Allocation, 11:11

Erratum (David Rein, 29 November 2011)

In their discussion section, the author¿s state;

A literature review of four previous studies showed a combination of some methodological limitations in all of them: short-term analyses[21,24]; intermediate outcome measures[21,23]; a model based entirely on secondary sources[22]; or a biased sensitivity analysis[23].

As the author of reference 23, I would like to point out that our paper did not contain a sensitivity analysis. The author¿s accusation of bias cannot be true and should be corrected. read full comment

Comment on: Perman et al. Cost Effectiveness and Resource Allocation, 9:4

GIGO (Kathryn Stephens, 29 November 2011)

It's too bad money is wasted on a false foundation: CFS patients severely ill for 15-20-25 years, were not diagnosed using the CDC's flawed Empirical Definition. (See Leonard Jason's studies) that deleted the serious neurological and immune deficits/abnormalities. (See Canadian Consensus Criteria.) Reeves, Emory and Abt at it again! read full comment

Comment on: Lin et al. Cost Effectiveness and Resource Allocation, 9:1

EVIDEM: an adaptable pragmatic open-source MCDA-based framework for accountable healthcare decisionmaking and priority setting (Mireille Goetghebeur, 20 October 2011)

We would like to thank Youngkong et al for providing an opportunity to clarify a few important points regarding the EVIDEM framework (1,2). In their commentary on the "usefulness of the EVIDEM framework for priority setting across a broad range of interventions", Youngkong et al report that "the EVIDEM framework ignores the contextual nature of priority setting". The EVIDEM framework is intended to be adapted to local context, and actually includes a Contextual Tool to facilitate this process ( The Contextual Tool prompts decisionmakers to identify their specific priorities and feasibility issues, and facilitates integration of these specific criteria into the framework. The framework is currently being tested and adapted by decisionmakers in several jurisdictions around the... read full comment

Comment on: Youngkong et al. Cost Effectiveness and Resource Allocation, 9:8

Adverse effects of hypnotic treatments (Daniel Kripke, 11 July 2011)

As a humble scientist with only 49 years experience in sleep research, I find myself confused by the sophisticated economic analyses of Scott et al. on the cost-effectiveness of treating insomnia. Could it be that the economic models estimate the cost-benefits of successful insomnia treatment versus non-treatment but do not estimate the costs of adverse effects of treatment? For an old guy, reading gets a little blurry. I simply couldn¿t see in Figure 3 where those clever pathways allowed for the possibility of adverse... read full comment

Comment on: Scott et al. Cost Effectiveness and Resource Allocation, 9:10