Cost-effectiveness of hybrid closed-loop artificial pancreas systems in patients with type 1 diabetes

Table of Contents

1 Introduction

1.1 Background and Critique of Literature

1.2 Research Gap and Rationale for Study

1.3 Research Questions, Aims, and Objectives of Study

2 Methodology

2.1 Systematic Literature Search

2.2 Grey Literature Search

2.3 Eligibility Criteria

2.4 Selection Process

2.5 Assessment of Methodological Quality

2.6 Data Extraction

2.7 Data Synthesis

2.8 Risk of Bias Assessment

3 Results

3.1 Study Selection

3.2 Characteristics of Included Studies

3.3 Critical Appraisal of Included Studies

3.4 Findings of the Review

3.5 Research Pipeline for Cost-Effectiveness of HCL

4 Discussion

4.1 Interpretation of Results in the Context of Existing Evidence

4.2 Limitations of the Evidence Included in the Review

4.3 Strengths and Limitations of the Review Process

4.4 Implications of Results for Practice and Policy

4.5 Implications of Results for the Future Research Agenda

4.6 Conclusion

5 Final Notes

5.2 Registration and Protocol

5.3 Support and Competing Interests

5.4 Availability of Material

Objectives and Themes

The primary objective of this dissertation is to conduct a systematic review and critical analysis of existing economic evaluations concerning hybrid closed-loop (HCL) artificial pancreas systems for patients with type 1 diabetes, aimed at assessing their cost-effectiveness to inform clinical policy and future research.

• Critical synthesis of health economic evidence for HCL artificial pancreas systems.
• Evaluation of methodological quality in current cost-effectiveness studies.
• Comparative analysis of incremental cost-effectiveness ratios (ICERs).
• Identification of the research pipeline for upcoming economic evaluations.
• Determination of cost-effectiveness as a basis for reimbursement and clinical adoption.

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Summary of Chapters

1 Introduction: Provides the global context of diabetes mellitus, the clinical challenges of T1D management, and establishes the rationale for evaluating the cost-effectiveness of HCL systems.

2 Methodology: Outlines the systematic review process, including search strategies in medical databases, eligibility criteria, and the application of JBI and CHEERS guidelines for quality assessment.

3 Results: Presents the findings from the systematic search, including study selection, characteristics, critical appraisals, and a synthesized overview of cost-effectiveness data and the future research pipeline.

4 Discussion: Interprets the review's findings, highlights strengths and limitations of the available evidence, and provides implications for clinical practice, health policy, and future research agendas.

5 Final Notes: Confirms the administrative aspects of the study, including protocol registration, non-funded status, and the location of supporting appendices.

Keywords

Systematic review, diabetes technology, closed-loop systems, economic evaluation, cost-effectiveness, quality assessment, type 1 diabetes, health economics, artificial pancreas, clinical outcomes, reimbursement, insulin delivery, medical device, cost-effectiveness plane, ICER.

Frequently Asked Questions

What is the core focus of this dissertation?

This work examines the cost-effectiveness of hybrid closed-loop (HCL) artificial pancreas systems compared to standard diabetes treatment options for patients with type 1 diabetes.

What are the central research themes?

The themes include the clinical and economic impact of automated insulin delivery, the standardization of health economic reporting, and the appraisal of existing trial evidence.

What is the primary research objective?

The goal is to determine if HCL systems serve as a cost-effective alternative by aggregating and evaluating evidence from available health economic literature.

Which scientific methodology is utilized?

The author employs a systematic review methodology, adhering to PRISMA 2020 and JBI guidelines, complemented by a narrative synthesis of economic outcomes.

What topics are covered in the main body?

The main body covers the background of diabetes technology, systematic search strategies, methodological quality appraisal of included studies, detailed findings on ICERs, and an analysis of the future research pipeline.

How is this research characterized by keywords?

The work is defined by terms such as systematic review, cost-effectiveness, HCL, type 1 diabetes, and economic evaluation.

How were cost-effectiveness ratios standardized across different currencies?

The author applied OECD purchasing power parities and adjusted for inflation using UK consumer price indices to convert results into 2021 GBP per QALY.

What does the author conclude regarding the cost-effectiveness of HCL systems?

The research indicates that HCL systems generally demonstrate cost-effectiveness in clinical practice, though limited long-term data and methodological heterogeneity require further high-quality research.