20. The potential cost implications of applying the recommendations should be considered

SIGN recognises that, in a national health service with limited resources and ever-increasing costs, the ability to cost individual items of care and weigh these against some quantification of patient benefit is important. However, the science of economic analysis of health care is at a relatively early stage and many published studies do not meet the required methodological standard to be incorporated as part of the evidence base for a guideline. Where there is published economic evidence, this has to be identified and evaluated in a consistent manner. Health economic databases are included in the coverage of literature search and studies identified from those searches are evaluated against standard criteria. This evidence can be considered alongside clinical evidence at the considered judgement stage (see item 9).

• Resource implications questionnaire