Review for 10.1186/1471-230X-11-93 (2011)

Reviewer's report
Title:Cost-Effectiveness of a Mailed Educational Reminder to Increase
Colorectal Cancer Screening
Version: 1Date:8 November 2010
Reviewer: Catherine Lejeune
Reviewer's report:
Participation rate is known to greatly contribute to the success of a mass
screening programme. European randomized trials have demonstrated that a
minimum of 50% participation rate was required to reduce significantly CRC
mortality in the general population. In this context, assessing the impact of a new
modality to promote CRC screening is relevant. The methodology used in this
article is adequate. The paper is globally well written, even if some
methodological points need to be clarified.
Minor essentials revisions
1-Abstract page 2:
a-In the Methods paragraph: it is not clear what the “usual care group” consists
of. The authors should describe this option very shortly.
b-in the Conclusions paragraph: it is not clear what the authors mean by
“compared to other patient-directed interventions for CRC screening”.
2-Introduction page 3
a-Is the reference 6 really relevant to justify CRC incidence reduction?
b-the authors should indicate what “VA” means before using the abbreviation.
3-page 6, in the Intervention paragraph:
a-I am sorry, but I was not able to find the appendix 1.
b-what does IRB mean? Please indicate what it is before using the abbreviation.
4-page 6: in the Cost Analysis paragraph:
a-I do not understand why the reference 23 has been introduced here to justify
the point of view of the payer. This reference is related to the cost of a physical
activity. Please find a more appropriate reference, if introducing a reference
appears relevant to justify the study’s perspective.
b-the sentences “Thus, data collection for research purposes was not included in
the analysis……..mailed reminder study” needs to be clarified. I do not
understand the link (expressed by “thus”) between the choice of the point of view
and the fact that economic data have not been collected. I also do not
understand what the authors mean with “mailed reminder study”. This needs to
be clarified.
c-to my opinion, the paragraph “overhead costs….. cost analysis” should be
found in the paragraph entitled “costs of the intervention”. More globally, the
description of economic parameters needs to be more consistent for the reader.
5-page 7: What does GI mean ? Please indicate what it is before using the
abbreviation
6-page 8: The sentence “in addition to calculating….. promotion interventions”
should be found in the Discussion section.
7-page 15: The authors indicate that costs and ICR were markedly lower. I
agree, but comparisons were also quite difficult due to different target population
and different promotion modalities. Please be careful in your conclusion and
perhaps moderate it.
8-page 15: Given the fact that all details are given in the text concerning other
promotions programs, I am not sure that the table 3 is required.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests