Deriving Input Parameters for Cost-Effectiveness Modeling: Taxonomy of Data Types and Approaches to Their Statistical Synthesis

Saramago, Pedro; Manca, Andrea; Sutton, Alex J.

doi:10.1016/j.jval.2012.02.009

Cited by 40 publications

(33 citation statements)

References 127 publications

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“…Increasingly, data sharing is promoted in research [ 43 , 44 ] and this example highlights how use of IPD allows the development of more informative and flexible models that are better able to summarise existing evidence. However, it is important to acknowledge that accessing and analysing IPD can be time consuming and may cause delay [ 4 ]. The process needs to be well planned and implemented.…”

Section: Discussionmentioning

confidence: 99%

“…Published work on NMA mainly focuses on the synthesis of aggregate data (AD) (sometimes called summary data, e.g. group means and standard errors available from study reports) [ 4 , 5 ]; however, methods have been developed that allow use of individual patient-level data (IPD) in NMA, specifically for binary and continuous data [ 6 - 8 ]. The appeal of including IPD in a NMA is that it is likely to reduce statistical heterogeneity across the network (and in this way help resolve possible inconsistencies); it may also allow subgroup effects to be estimated which in turn could guide more personalised treatment decisions [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Network meta-analysis of (individual patient) time to event data alongside (aggregate) count data

Saramago

Chuang

Soares

2014

BMC Med Res Methodol

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BackgroundNetwork meta-analysis methods extend the standard pair-wise framework to allow simultaneous comparison of multiple interventions in a single statistical model. Despite published work on network meta-analysis mainly focussing on the synthesis of aggregate data, methods have been developed that allow the use of individual patient-level data specifically when outcomes are dichotomous or continuous. This paper focuses on the synthesis of individual patient-level and summary time to event data, motivated by a real data example looking at the effectiveness of high compression treatments on the healing of venous leg ulcers.MethodsThis paper introduces a novel network meta-analysis modelling approach that allows individual patient-level (time to event with censoring) and summary-level data (event count for a given follow-up time) to be synthesised jointly by assuming an underlying, common, distribution of time to healing. Alternative model assumptions were tested within the motivating example. Model fit and adequacy measures were used to compare and select models.ResultsDue to the availability of individual patient-level data in our example we were able to use a Weibull distribution to describe time to healing; otherwise, we would have been limited to specifying a uniparametric distribution. Absolute effectiveness estimates were more sensitive than relative effectiveness estimates to a range of alternative specifications for the model.ConclusionsThe synthesis of time to event data considering individual patient-level data provides modelling flexibility, and can be particularly important when absolute effectiveness estimates, and not just relative effect estimates, are of interest.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Network meta-analysis of (individual patient) time to event data alongside (aggregate) count data

Saramago

Chuang

Soares

2014

BMC Med Res Methodol

Self Cite

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“…A third investigator (RAT) adjudicated discrepancies in article selection. If multiple data sources existed for an input variable they were combined as a weighted mean based on study sample size . Nineteen documents or articles were identified for model inputs spanning the time frame of 1994–2014.…”

Section: Methodsmentioning

confidence: 99%

Cost‐effectiveness of the Cardiac Component of the Focused Assessment of Sonography in Trauma Examination in Blunt Trauma

Hall

Omer

Moore

et al. 2016

Academic Emergency Medicine

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Background: Blunt cardiac injury severe enough to require surgical intervention (sBCI) is an exceedingly rare event occurring in approximately 1 out of every 1600 trauma patients. While performing the cardiac component of the Focused Assessment of Sonography in Trauma (cFAST) exam is effective in penetrating trauma, it is unclear whether it is of value in blunt trauma given the low prevalence of sBCI, the imperfect test characteristics of the FAST exam, and the rate of incidental pericardial effusion.

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“…Hazard ratios for remission and treatment failure with lamotrigine and valproate were assumed constant . Additional data on allele prevalence, incidence of ADRs, and mortality statistics were obtained from purposive reviews of the literature, in line with standard methodology for populating economic models . All clinical parameter estimates are listed in Table .…”

Section: Methodsmentioning

confidence: 99%

Cost‐effectiveness of screening for HLA‐A31:01* prior to initiation of carbamazepine in epilepsy

et al. 2015

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SUMMARYObjective: Carbamazepine causes severe cutaneous adverse drug reactions that may be predicted by the presence of the HLA-A*31:01 allele in northern European populations. There is uncertainty as to whether routine testing of patients with epilepsy is cost-effective. We conducted an economic evaluation of HLA-A*31:01 testing from the perspective of the National Health Service (NHS) in the United Kingdom. Methods: A short-term, decision analytic model was developed to estimate the outcomes and costs associated with a policy of routine testing (with lamotrigine prescribed for patients who test positive) versus the current standard of care, which is carbamazepine prescribed without testing. A Markov model was used to estimate total costs and quality-adjusted life-years (QALYs) over a lifetime to account for differences in drug effectiveness and the long-term consequences of adverse drug reactions. Results: Testing reduced the expected rate of cutaneous adverse drug reactions from 780 to 700 per 10,000 patients. The incremental cost-effectiveness ratio for pharmacogenetic testing versus standard care was £12,808 per QALY gained. The probability of testing being cost-effective at a threshold of £20,000 per QALY was 0.80, but the results were sensitive to estimated remission rates for alternative antiepileptic drugs (AEDs). Significance: Routine testing for HLA-A*31:01 in order to reduce the incidence of cutaneous adverse drug reactions in patients being prescribed carbamazepine for epilepsy is likely to represent a cost-effective use of health care resources.

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Deriving Input Parameters for Cost-Effectiveness Modeling: Taxonomy of Data Types and Approaches to Their Statistical Synthesis

Abstract: The use of the taxonomy developed in this article hopes to improve the quality of the synthesis of evidence informing decision models by bringing to the attention of health economics modelers recent methodological developments in this field.

Cited by 40 publications

References 127 publications

Network meta-analysis of (individual patient) time to event data alongside (aggregate) count data

Network meta-analysis of (individual patient) time to event data alongside (aggregate) count data

Cost‐effectiveness of the Cardiac Component of the Focused Assessment of Sonography in Trauma Examination in Blunt Trauma

Cost‐effectiveness of screening for HLA‐A31:01* prior to initiation of carbamazepine in epilepsy

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Deriving Input Parameters for Cost-Effectiveness Modeling: Taxonomy of Data Types and Approaches to Their Statistical Synthesis

Abstract: The use of the taxonomy developed in this article hopes to improve the quality of the synthesis of evidence informing decision models by bringing to the attention of health economics modelers recent methodological developments in this field.

Cited by 40 publications

References 127 publications

Network meta-analysis of (individual patient) time to event data alongside (aggregate) count data

Network meta-analysis of (individual patient) time to event data alongside (aggregate) count data

Cost‐effectiveness of the Cardiac Component of the Focused Assessment of Sonography in Trauma Examination in Blunt Trauma

Cost‐effectiveness of screening for HLA‐A*31:01 prior to initiation of carbamazepine in epilepsy

Contact Info

Product

Resources

About

Cost‐effectiveness of screening for HLA‐A31:01* prior to initiation of carbamazepine in epilepsy