OBJECTIVES: Published cost-effectiveness literature regarding surgical devices and procedures should be valid, useful, and transparent. Since users often need to be able to substitute local costs or resource utilization into economic models, publications need to disclose sufficient information about the methodology and costs of resources used rather than simply aggregate or average cost per case data. The primary objective of this study was to examine the extent of useful disclosure of reported dollars per health-care resource (HCR) in surgery performed in all patient populations. The secondary objective was to determine the extent to which economic principles and disclosure (i.e. validity) existed. METHODS: “Dollars per HCR” were obtained from literature searches conducted in two databases using the search terms “surgery”, “cost”, and “cost effectiveness”. Mean, standard deviation, and confidence intervals were determined for each type of HCR. All articles were individually critiqued for internal and external validity based on ten created problem categories. RESULTS: After eliminating 122 articles that contained no cost information or analysis, twenty-five percent of 138 articles contained usable dollars per HCR data. All descriptive statistics will be reported for each category. Over 74 percent of the articles were missing one or more of the following definitions or disclosures: fixed versus variable costs, dollars per HCR, perspective, and sensitivity analysis. The greatest number of articles was found to have five problems, while the lowest number had one problem. Lack of transparency was also evident. CONCLUSIONS: Published cost-effective literature cannot be relied on nor easily utilized due to the lack of availability of dollars per HCR and the weak validity of such literature. Relying on invalid and useless published literature can lead to unwarranted conclusions and an inability to determine cost-effectiveness in specific settings. While site-specific research will likely be necessary, so is the need to critically evaluate such literature before blindly using it for decision-making.