How Many Intensive Care Beds are Justifiable for Hospital Pandemic Preparedness? A Cost-effectiveness Analysis for COVID-19 in Germany

  1. Afschin Gandjour

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  1. Version published to 10.1007/s40258-020-00632-2
  2. ScreenIT

    SciScore for 10.1101/2020.07.27.20162743: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableI performed all calculations for men and women separately and then aggregated the results.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Cost analysis: For the cost analysis, I took a societal viewpoint.
    Cost
    suggested: (COST, RRID:SCR_014098)
    Discounting: In the base-case analysis, I did not discount costs or health benefits, as the reported survival benefits from cancer treatment (Storm 2017), which were used to determine the economic value of a life year, were undiscounted as well.
    Storm
    suggested: (SToRM, RRID:SCR_006696)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The limitations of this study need to be acknowledged. First, there are reasons why the base-case analysis overestimates the NMB, i.e., underestimates the MCER. Some of these reasons were already described in the sensitivity analysis and include high mortality in the ICU and post discharge. Furthermore, this study did not include direct nonmedical costs, such as time and transportation costs, which are mandated by the societal perspective adopted in this paper. On the other hand, there are reasons to believe that the base case underestimates the NMB, i.e., overestimates the MCER. First, by including future medical costs along with the costs of hospitalizations in the first year after ICU discharge, some double counting of hospitalization costs may result. Furthermore, the DRG rates may not reflect true hospital costs and may yield a positive profit margin for ventilated patients (Welt 2020). Moreover, the productivity gains resulting from a reduction in mortality were not included due to the age distribution of averted deaths (the median age is 82 years) and the difficulty of disentangling deaths in relevant age groups (e.g., in the age group 50-69 years). Some of the biases mentioned in this and the previous paragraph may cancel each other out, however. In terms of the transferability of the results and conclusions of this study to other countries the usual caveats apply. The reasons for caution include between-country differences in clinical and epidemiological data, costs,...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. ScreenIT

    SciScore for 10.1101/2020.07.27.20162743: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Cost analysis For the cost analysis, I took a societal viewpoint.
    Cost
    suggested: (COST, SCR_014098)

    Data from additional tools added to each annotation on a weekly basis.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2020.07.27.20162743v1 on medRxiv