Is expert opinion reliable when estimating transition probabilities? The case of HCV-related cirrhosis in Egypt

BMC Medical Research Methodology

Yazdan Yazdanpanah¹  Mostafa K Mohamed⁸  Arnaud Fontanet⁶  Wagida A Anwar⁸  Mohammad El-Sayed³  Mohamed El Kassas²  Valérie Canva⁷  Gamal Esmat³  Aya Mostafa⁸  Sylvie Deuffic-Burban⁵  Dorothée Obach⁴  Anthony Cousien⁴ 

[1] Service de Maladies infectieuses et tropicales, Hôpital Bichat Claude Bernard, Paris, France;National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt;Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt;EA2694, Université Lille Nord de France, Lille, France;Inserm U995, Université Lille 2 – Lille Nord de France, Lille, France;Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France;Service des Maladies de l'Appareil Digestif et de la Nutrition, Hôpital Huriez, CHRU Lille, France;Department of Community, Environmental and Occupational Medicine, Faculty of medicine, Ain Shams University, Cairo, Egypt

关键词: HCV in Egypt;    Cognitive bias;    Risk perception;    Methodological bias;    Expert knowledge elicitation;    Delphi method;   

Others  :  866386
DOI  :  10.1186/1471-2288-14-39

 received in 2013-03-08, accepted in 2014-01-30,  发布年份 2014

【 摘 要 】

Background

Data on HCV-related cirrhosis progression are scarce in developing countries in general, and in Egypt in particular. The objective of this study was to estimate the probability of death and transition between different health stages of HCV (compensated cirrhosis, decompensated cirrhosis and hepatocellular carcinoma) for an Egyptian population of patients with HCV-related cirrhosis.

Methods

We used the “elicitation of expert opinions” method to obtain collective knowledge from a panel of 23 Egyptian experts (among whom 17 were hepatologists or gastroenterologists and 2 were infectiologists). The questionnaire was based on virtual medical cases and asked the experts to assess probability of death or probability of various cirrhosis complications. The design was a Delphi study: we attempted to obtain a consensus between experts via a series of questionnaires interspersed with group response feedback.

Results

We found substantial disparity between experts’ answers, and no consensus was reached at the end of the process. Moreover, we obtained high death probability and high risk of hepatocellular carcinoma. The annual transition probability to death was estimated at between 10.1% and 61.5% and the annual probability of occurrence of hepatocellular carcinoma was estimated at between 16.8% and 58.9% (depending on age, gender, time spent in cirrhosis and cirrhosis severity).

Conclusions

Our results show that eliciting expert opinions is not suited for determining the natural history of diseases due to practitioners’ difficulties in evaluating quantities. Cognitive bias occurring during this type of study might explain our results.

【 授权许可】

   
2014 Cousien et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 3.

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