DIRUM is a project funded by the Medical Research Council Network of Hubs for Trial Methodology Research (MRC HTMR) to compile a Database of Instruments for Resource Use Measurement. Led by Bangor University, and in collaboration with the Universities of Bristol, Birmingham, Simon Fraser University, and London School of Economics and Political Science, the aim is to create a practical, open-access database of resource-use questionnaires for use by trial health economists.

The database supports data navigation, sorting, searching, advanced filtering and for administrators record addition, modification, deletion, and file uploads.

To submit a resource use instrument (by which we mean any method such as questionnaire, diary to estimate resource use based on patient recall), please contact Professor Dyfrig Hughes, Professor of Pharmacoeconomics, Centre for Health Economics and Medicines Evaluation, Bangor University, Ardudwy, Normal Site, Bangor, UK. LL57 2PZ. E-Mail: info@dirum.org

DIRUM team: Professor Dyfrig Hughes and Dr Colin Ridyard (Bangor University, NWHTMR), Dr William Hollingworth, Dr Sian Noble and Dr Joanna Thorn (University of Bristol, ConDuCT), Professor Joanna Coast (University of Birmingham, MHTMR), Dr David Whitehurst (Simon Fraser University) and Professor Martin Knapp (London School of Economics and Political Science)


Background Information

Clinical trials are an important vehicle for capturing data on healthcare resource use. A wide variety of data collection methods are used. They include: patient self-report (e.g. questionnaires, diaries or interviews); use of routinely available data (e.g. medical records and general practitioner (GP) records); and use of expert panels. Each method has advantages and disadvantages. The use of routinely collected data, for instance, depends on accurate recording, and the standard of information technology infrastructure; and, is generally only available for some items of resource use. Eliciting expert opinion is convenient, but is not generally considered as a reliable or unbiased method of resource use estimation. Reliance on patient self-report (patient recall) places a cognitive burden on respondents [1] forcing them to comprehend the question, recollect the requested data, then evaluate and frame a response. Despite these limitations, and probably because of ease of implementation, the majority of trial-based economic evaluations rely on patient recall for at least one aspect of data collection.

Unlike patient-reported measures of health outcome, methods for collecting economic data are disparate, mostly unvalidated, and difficult to obtain. Health economists continually reinvent the wheel, developing new questionnaires (or modifying their own previously-used questionnaire) each time they are involved in a new clinical trial. We recently completed a review of UK National Institute of Health Research (NIHR) Health Technology Assessment (HTA) programme-funded trials [2] to assess the methods of resource use data collection and identified important differences in how data are collected. Our review identified 95 studies which included an economic analysis; of which 85 recorded patient-level resource use. Alarmingly, only 21 of these reported piloting their patient health care resource use questionnaires and only 28 reported validating their health care resource use data collection methods.

There are published guidelines and reviews on the conduct of economic evaluations alongside clinical trials, which outline the available methods for estimating health care resource use, and sources of unit costs [3-5]. However, there is no single database of resource use questionnaires and, to our knowledge, our paper [2] is the only systematic review of economic data collection methods within clinical trials.

We are developing a central database of resource use data collection questionnaires to:

  • support health economists involved in trial-based evaluations;
  • help improve future design and development of questionnaires; and
  • establish a research agenda on issues of content validity, construct validity, responsiveness and reliability of resource-use questionnaires


  • Bowling A. Mode of questionnaire administration can have serious effects on data quality. J Public Health (Oxf) 2005;27:281-91.
  • Ridyard C, Hughes D. Methods for the collection of resource use data within clinical trials: A systematic review of trials funded by the UK Health Technology Assessment programme. Value in Health 2010;13(8):867-72.
  • Glick HA, Doshi JA, Sonnad SS, Polsky D. Economic Evaluation in Clinical Trials. Oxford: Oxford University Press 2007.
  • Ramsey S, Willke R, Briggs A. et al. Good research practices for cost-effectiveness analysis alongside clinical trials: the ISPOR RCT-CEA Task Force report. Value Health 2005;8:521-33.
  • Johnston K, Buxton MJ, Jones DR et al. Assessing the costs of healthcare technologies in clinical trials. Health Technol Assess 1999;3:1-76.

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