Guidance on the use of complex systems models for economic evaluations of public health interventions

Breeze, Penny; Squires, Hazel; Ennis, Kate; Meier, Petra; Hayes, Kate; Lomax, Nik; Shiell, Alan; Kee, Frank; Vocht, Frank de; O’Flaherty, Martı́n; Gilbert, Nigel; Purshouse, Robin C.; Robinson, Stewart; Dodd, Peter J; Strong, Mark; Paisley, Suzy; Smith, Richard L.; Briggs, Andrew; Shahab, Lion; Occhipinti, Jo‐An; Lawson, Kenny; Bayley, Thomas; Smith, Robert W.; Boyd, Jennifer; Kadirkamanathan, Visakan; Cookson, Richard; Alava, Mónica Hernández; Jackson, Christopher; Karapici, Amanda; Sassi, Franco; Scarborough, Peter; Siebert, Uwe; Silverman, Eric; Vale, Luke; Walsh, Cathal; Brennan, Alan

doi:10.1002/hec.4681

Cited by 22 publications

(3 citation statements)

References 116 publications

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“…However, an advantage of ABM is that it is possible to synthesize a wider collection of knowledge and evidence than is possible with data-driven approaches like SEM. Guidance on when to use complex systems models, including ABM, has been published to help analysts decide when the additional complexity offered by such models is worthwhile (Breeze et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

The long‐term effectiveness and cost‐effectiveness of public health interventions; how can we model behavior? A review

Squires,

Kelly,

Gilbert

et al. 2023

Health Economics

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The effectiveness and cost of a public health intervention is dependent on complex human behaviors, yet health economic models typically make simplified assumptions about behavior, based on little theory or evidence. This paper reviews existing methods across disciplines for incorporating behavior within simulation models, to explore what methods could be used within health economic models and to highlight areas for further research. This may lead to better‐informed model predictions. The most promising methods identified which could be used to improve modeling of the causal pathways of behavior‐change interventions include econometric analyses, structural equation models, data mining and agent‐based modeling; the latter of which has the advantage of being able to incorporate the non‐linear, dynamic influences on behavior, including social and spatial networks. Twenty‐two studies were identified which quantify behavioral theories within simulation models. These studies highlight the importance of combining individual decision making and interactions with the environment and demonstrate the importance of social norms in determining behavior. However, there are many theoretical and practical limitations of quantifying behavioral theory. Further research is needed about the use of agent‐based models for health economic modeling, and the potential use of behavior maintenance theories and data mining.

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Section: Discussionmentioning

confidence: 99%

The long‐term effectiveness and cost‐effectiveness of public health interventions; how can we model behavior? A review

Squires,

Kelly,

Gilbert

et al. 2023

Health Economics

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“…At present, there are five commonly used economic evaluation models-the decision tree model, Markov model, partition survival model, discrete event simulation model, and system dynamics model [29,30]. The models employed in the 12 studies are decision tree, Markov, decision tree plus Markov, and multiple regression models.…”

Section: Model Typementioning

confidence: 99%

Systematic review of the economic evaluation model of assisted reproductive technology

Si,

Tan,

2024

Health Econ Rev

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Background With the increasing demand for fertility services, it is urgent to select the most cost-effective assisted reproductive technology (ART) treatment plan and include it in medical insurance. Economic evaluation reports are an important reference for medical insurance negotiation. The aim of this study is to systematically evaluate the economic evaluation research of ART, analyze the existing shortcomings, and provide a reference for the economic evaluation of ART. Methods PubMed, EMbase, Web of Science, Cochrane Library and ScienceDirect databases were searched for relevant articles on the economic evaluation of ART. These articles were screened, and their quality was evaluated based on the Comprehensive Health Economics Evaluation Report Standard (CHEERS 2022), and the data on the basic characteristics, model characteristics and other aspects of the included studies were summarized. Results One hundred and two related articles were obtained in the preliminary search, but based on the inclusion criteria, 12 studies were used for the analysis, of which nine used the decision tree model. The model parameters were mainly derived from published literature and included retrospective clinical data of patients. Only two studies included direct non-medical and indirect costs in the cost measurement. Live birth rate was used as an outcome indicator in half of the studies. Conclusion Suggesting the setting of the threshold range in the field of fertility should be actively discussed, and the monetary value of each live birth is assumed to be in a certain range when the WTP threshold for fertility is uncertain. The range of the parameter sources should be expanded. Direct non-medical and indirect costs should be included in the calculation of costs, and the analysis should be carried out from the perspective of the whole society. In the evaluation of clinical effect, the effectiveness and safety indexes should be selected for a comprehensive evaluation, thereby making the evaluation more comprehensive and reliable. At least subgroup analysis based on age stratification should be considered in the relevant economic evaluation.

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“…One of the advantages of modeling is its ability to use different types of inputs from various sources and to reveal the logical connection between these inputs and outputs of interest. A model can accommodate data from prevalence studies, prospective studies, controlled trials, meta-analyses, routine surveillance, expert opinions, and assumptions [ 15 ]. However, different types of data sources are most likely associated with uncertainty of the model outputs.…”

Section: Introductionmentioning

confidence: 99%

Future Projections of Diabetes-Related Amputations in Eastern Saudi Arabia During 2022–2045 Using a Validated Epidemiological Model

Al-Quwaidhi,

AlSaleh

2023

Cureus

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Introduction: Diabetes-related amputations (DRA) are associated with significant morbidity and mortality. There are limited studies on the burden of this condition and its future projections in Saudi Arabia. Objectives: To estimate future forecasts in the burden of DRA (number of cases and mortalities) among adult diabetics (aged ≥20 years) in Al-Ahsa, Eastern Region of Saudi Arabia from 2022 to 2045. Methods: A simulation epidemiological model was designed and validated. It is a simple discrete-state model composed of multiple states, in which diabetics make annual transitions to either 'Major Amputations', 'Minor Amputations', or 'No Amputations' states, and then to two states of mortalities. The data inputs required are minimal, including the total diagnosed cases of diabetes for 2022 and transition parameters obtained from recent published literature. The model used some reasonable assumptions and scenarios for testing potential uncertainties around the model outputs. Model validation was conducted by comparing its estimates with the observed local data from two main hospitals in Al-Ahsa for 2022. Results: The model projected that the total number of DRA among diabetics in Al-Ahsa will increase from 129 (uncertainty interval (UI): 103-154) in 2022 to 169 (UI: 136-203) in 2030 and 227 (UI: 182-272) in 2045, assuming that the incidence rates of major and minor amputations among diabetics will remain constant. However, assuming that these incidence rates will show a gradual decline of 20% every three years, the model predicted the total number of DRA to decrease from 103 (UI: 82-124) in 2022 to 91 (UI: 73-110) in 2030 and 61 (UI: 49-74) in 2045. Conclusion: DRA impose a considerable burden on patients and the healthcare system, despite the possibility of a potential decrease in incidence rates.

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Guidance on the use of complex systems models for economic evaluations of public health interventions

Cited by 22 publications

References 116 publications

The long‐term effectiveness and cost‐effectiveness of public health interventions; how can we model behavior? A review

The long‐term effectiveness and cost‐effectiveness of public health interventions; how can we model behavior? A review

Systematic review of the economic evaluation model of assisted reproductive technology

Future Projections of Diabetes-Related Amputations in Eastern Saudi Arabia During 2022–2045 Using a Validated Epidemiological Model

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