Prm224 - Are Potentially Avoidable Hospitalizations Explained by Primary Care? Beware of Spatial Heterogeneity.

Abstract

Analysis (MCDA) is a popular decision tool as it permits to summarize the benefits and the risks of a drug in a single utility score, accounting for the preferences of the decision-makers. However, the utility score is often derived using a linear model which might lead to counter-intuitive conclusions, for example drugs with no benefit or extreme risk could be recommended. Moreover, it assumes that the relative importance of benefits against risks is constant for all levels of benefit or risk, which might not hold for all drugs. Further methodological developments are required to overcome these issues. METHODS: . We propose Scale Loss Score (SLoS) as a new tool for the BR assessment, which offers the same advantages as MCDA but has, in addition, desirable properties permitting to avoid recommendations of non-effective or extremely unsafe treatments, and to tolerate larger increases in risk for a given increase in benefit when the amount of benefit is small than when it is high. RESULTS: . We present an application to a real case study on telithromycin in Community Acquired Pneumonia and Acute Bacterial Sinusitis, and we investigated the patterns of behavior of SLoS, as compared to MCDA, in a comprehensive simulation study. CONCLUSIONS: . Scale Loss Score (SLoS) is a novel, simple and valuable tool for BR assessment.