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BACKGROUND: Over the last 10 years several systematic reviews have been published on the cost-effectiveness of telemedicine studies. Most reviews have concluded that there is not much difference in the cost-effectiveness when delivering health services via telemedicine or by conventional means. We are not aware of any systematic review looking at the systematic reviews of cost-effectiveness of telemedicine. This study was designed to identify published systematic reviews on the cost-effectiveness of telemedicine studies and to undertake a quality assessment of the identified systematic reviews. MATERIALS AND METHODS: We searched six electronic databases, including Medline, Embase, and the NHS Economic Evaluation Database, combining "review" terms with "telemedicine" terms to identify systematic reviews. RESULTS: We identified 4,116 potential abstracts. Nine systematic reviews met the inclusion criteria, which looked at the cost-effectiveness of telemedicine in general. All reviews were similar in terms of their stated purpose, and the objectives were clear. Three of the reviews did not use a checklist for the economic evaluation studies included in their review. The quality assessment found that five of the nine reviews had minimal flaws. CONCLUSIONS: Even though the general quality of reporting of the reviews was fine, we have found that conclusions cannot be drawn on the cost-effectiveness of telemedicine applications based on the methodological flaws in the economic analysis of the studies included in the reviews. Over time, reporting of cost-effectiveness has generally improved; however, there is still room for improvement, and authors need to use the recommended checklists for economic evaluations.
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