Employing early decision analytic modelling to informeconomic evaluation in health care: theory & practice

R Medicine (General);HB Economic Theory

Boyd, Kathleen Anne ; Briggs, Andrew

University:University of Glasgow

Department:Institute of Health and Wellbeing

关键词: Economic evaluation, decision analytic modelling, value of information, cost-effectiveness analysis;   

Others  :  http://theses.gla.ac.uk/3685/1/2012BoydPhD.pdf

来源: University of Glasgow

【 摘 要 】

Decision analytic modelling (DAM) is a mathematical technique which is used to structure and synthesise evidence in order to inform decision making, given uncertainty.Decision models are an ideal tool for undertaking economic evaluations as they enable a wide range of data on costs and effects to be synthesised within the model in order to derive cost-effectiveness outcomes.The iterative framework for economic appraisal has been proposed as good practice for undertaking economic evaluations (1), and DAM plays a key role within this framework.In particular there is a role for early stage DAM prior to primary research, to provide an indication of the potential cost-effectiveness of a new health technology (2) given current evidence, and the use of value of information (VOI) techniques to help inform further research priority setting. In practice, support and funding for early stage DAM and full exploitation of VOI techniques is rare.The aim of this thesis is to examine the role for early decision analytic modelling in informing research priorities and the design of future studies in a health care setting. This thesis explores the feasibility, merits and drawbacks of undertaking early DAM and considers potential reasons as to why it has not been more widely implemented.This thesis demonstrates the value and importance of early DAM; in both an ‘ideal’ setting and also in a less desirable, time-constrained setting. Applying early DAM and VOI techniques enables researchers to provide relevant conclusions and recommendations to decision makers, who can make informed decisions as to whether a new intervention should be adopted (or rejected), or whether further information is required to help make the decision; as opposed to making decisions based on subjective reasoning.There is considerable merit with employing early DAM for health care research, such as reduced uncertainty, reduction of costs and efficiency gains, however, some drawbacks exist in terms of whether it is always viable to fully exploit VOI analyses, which may hinder widespread support both inside and out-with the health economics community.