Accounting for Heterogeneity in Relative Treatment Effects for Use in Cost-Effectiveness Models and Value-of-Information Analyses
We describe how covariates can be included in a network meta-analysis model and how the output from such an analysis can be used in a CEA model. We outline a model selection procedure to help choose between competing models and stress the importance of clinical input. We illustrate the approach with a health technology assessment of intravenous immunoglobulin for the management of adult patients with severe sepsis in an intensive care setting, which exemplifies how risk of bias information can be incorporated into CEA models. We show that the results of the CEA and value-of-information analyses are sensitive to the model a...
Source: Medical Decision Making - June 16, 2015 Category: Health Management Authors: Welton, N. J., Soares, M. O., Palmer, S., Ades, A. E., Harrison, D., Shankar-Hari, M., Rowan, K. M. Tags: Original Articles Source Type: research
Cost-Effectiveness Uncertainty Analysis Methods: A Comparison of One-Way Sensitivity, Analysis of Covariance, and Expected Value of Partial Perfect Information
Conclusions. Evidence across models suggests influential input rank agreement between 1-way and more advanced uncertainty analyses for relatively linear models with uncorrelated parameters but less agreement for less linear models. Although each method provides unique information, the additional resources needed to generate and communicate advanced analyses should be weighed, especially when outcome decision uncertainty is low. For less linear models or those with correlated inputs, performing and reporting deterministic and probabilistic uncertainty analyses appear prudent and conservative. (Source: Medical Decision Making)
Source: Medical Decision Making - June 16, 2015 Category: Health Management Authors: Campbell, J. D., McQueen, R. B., Libby, A. M., Spackman, D. E., Carlson, J. J., Briggs, A. Tags: Original Articles Source Type: research
Computing Expected Value of Partial Sample Information from Probabilistic Sensitivity Analysis Using Linear Regression Metamodeling
In this study, we propose a novel practical approach for conducting VOI analysis using a combination of probabilistic sensitivity analysis, linear regression metamodeling, and unit normal loss integral function—a parametric approach to VOI analysis. We adopt a linear approximation and leverage a fundamental assumption of VOI analysis, which requires that all sources of prior uncertainties be accurately specified. We provide examples of the approach and show that the assumptions we make do not induce substantial bias but greatly reduce the computational time needed to perform VOI analysis. Our approach avoids the need...
Source: Medical Decision Making - June 16, 2015 Category: Health Management Authors: Jalal, H., Goldhaber-Fiebert, J. D., Kuntz, K. M. Tags: Original Articles Source Type: research
Estimating the Expected Value of Sample Information Using the Probabilistic Sensitivity Analysis Sample: A Fast, Nonparametric Regression-Based Method
We describe a fast nonparametric regression-based method for estimating per-patient EVSI that requires only the probabilistic sensitivity analysis sample (i.e., the set of samples drawn from the joint distribution of the parameters and the corresponding net benefits). The method avoids the need to sample from the posterior distributions of the parameters and avoids the need to rerun the model. The only requirement is that sample data sets can be generated. The method is applicable with a model of any complexity and with any specification of model parameter distribution. We demonstrate in a case study the superior efficienc...
Source: Medical Decision Making - June 16, 2015 Category: Health Management Authors: Strong, M., Oakley, J. E., Brennan, A., Breeze, P. Tags: Original Articles Source Type: research
Handling Parameter Uncertainty in Cost-Effectiveness Models Simply and Responsibly
(Source: Medical Decision Making)
Source: Medical Decision Making - June 16, 2015 Category: Health Management Authors: Kim, S.-Y., Russell, L. B., Sinha, A. Tags: Editorials Source Type: research
Value of Information: We've Got Speed, What More Do We Need?
(Source: Medical Decision Making)
Source: Medical Decision Making - June 16, 2015 Category: Health Management Authors: Welton, N. J., Thom, H. H. Z. Tags: Editorials Source Type: research
Cognitive Biases and Heuristics in Medical Decision Making: A Critical Review Using a Systematic Search Strategy
Conclusions. Most of the studies on biases and heuristics in medical decision making are based on hypothetical vignettes, raising concerns about applicability of these findings to actual decision making. Biases and heuristics have been underinvestigated in medical personnel compared with patients. (Source: Medical Decision Making)
Source: Medical Decision Making - May 5, 2015 Category: Health Management Authors: Blumenthal-Barby, J. S., Krieger, H. Tags: Review Source Type: research
Shared Decision Making in Senior Medical Students: Results from a National Survey
Conclusion. Despite limited exposure and training, Peruvian medical students aspire to practice shared decision making but their current attitude reflects the less participatory approaches they see role modeled by their teachers. (Source: Medical Decision Making)
Source: Medical Decision Making - May 5, 2015 Category: Health Management Authors: Zeballos-Palacios, C., Quispe, R., Mongilardi, N., Diaz-Arocutipa, C., Mendez-Davalos, C., Lizarraga, N., Paz, A., Montori, V. M., Malaga, G. Tags: Brief Reports Source Type: research
Adapting Scott and Bruce's General Decision-Making Style Inventory to Patient Decision Making in Provider Choice
Conclusions. This research provides evidence for the contextuality of decision-making style to specific choice situations. Using a limited set of indicators, this report proposes the patient decision-making style inventory as valid and feasible tool to assess patients’ decision propensities. (Source: Medical Decision Making)
Source: Medical Decision Making - May 5, 2015 Category: Health Management Authors: Fischer, S., Soyez, K., Gurtner, S. Tags: Brief Reports Source Type: research
Doctors and Numbers: An Assessment of the Critical Risk Interpretation Test
Conclusions. Our results provide supporting evidence for the reliability and validity of the CRIT as an index of critical risk interpretation abilities, which is acceptable and feasible to administer in an educational setting. (Source: Medical Decision Making)
Source: Medical Decision Making - May 5, 2015 Category: Health Management Authors: Caverly, T. J., Prochazka, A. V., Combs, B. P., Lucas, B. P., Mueller, S. R., Kutner, J. S., Binswanger, I., Fagerlin, A., McCormick, J., Pfister, S., Matlock, D. D. Tags: Original Articles Source Type: research
Is Patients' Numeracy Related to Physical and Mental Health?
Conclusions. Our research documents for the first time that self-reported numeracy is related to perceptions of health, whereas objective numeracy is related to actual health, laying the groundwork for future research on the effect of numeracy on health outcomes. (Source: Medical Decision Making)
Source: Medical Decision Making - May 5, 2015 Category: Health Management Authors: Garcia-Retamero, R., Andrade, A., Sharit, J., Ruiz, J. G. Tags: Original Articles Source Type: research
The Effect of Different Graphical and Numerical Likelihood Formats on Perception of Likelihood and Choice
Conclusion. Perception of likelihood differs significantly depending on the numerical format used. The 1-in-X format yields higher perceived likelihoods and it appears to be the easiest format to interpret. Graphs primarily affect perception of likelihood of people with lower numerical aptitude. These effects should be taken into account when discussing medical risks with patients. (Source: Medical Decision Making)
Source: Medical Decision Making - May 5, 2015 Category: Health Management Authors: Oudhoff, J. P., Timmermans, D. R. M. Tags: Original Articles Source Type: research
Decision-making Processes among Prostate Cancer Survivors with Rising PSA Levels: Results from a Qualitative Analysis
Conclusions. Prostate cancer survivors’ decision-making processes for the treatment of a rising PSA are markedly different from those of the initial diagnosis of prostate cancer. Because patients experience heightened distress and rely more heavily on their physicians’ recommendations with a rising PSA, interactions with the health care provider provide an excellent opportunity to address and assist patients with managing the uncertainty and distress inherent with rising PSA levels. (Source: Medical Decision Making)
Source: Medical Decision Making - May 5, 2015 Category: Health Management Authors: Shen, M. J., Nelson, C. J., Peters, E., Slovin, S. F., Hall, S. J., Hall, M., Herrera, P. C., Leventhal, E. A., Leventhal, H., Diefenbach, M. A. Tags: Original Articles Source Type: research
Clinicians' Perceptions of the Benefits and Harms of Prostate and Colorectal Cancer Screening
Conclusions. Targeting clinicians’ gist of screening, for example through graphical displays that allow clinicians to make gist-based relative magnitude comparisons, may influence their risk perception and possibly reduce overrecommendation of screening. (Source: Medical Decision Making)
Source: Medical Decision Making - May 5, 2015 Category: Health Management Authors: Elstad, E. A., Sutkowi-Hemstreet, A., Sheridan, S. L., Vu, M., Harris, R., Reyna, V. F., Rini, C., Earp, J. A., Brewer, N. T. Tags: Original Articles Source Type: research
Relationship between Physicians' Uncertainty about Clinical Assessments and Patient-Centered Recommendations for Colorectal Cancer Screening in the Elderly
Conclusions. Our findings demonstrate that when the results of clinical assessments do not lead to obvious screening decisions or when physicians feel uncertain about their clinical assessments, they are more likely to make patient-centered recommendations. Existing uncertainty frameworks do not adequately describe the uncertainty associated with patient-centered recommendations found in this study. Adapting or modifying these frameworks to better reflect the constructs associated with uncertainty and the interactions between uncertainty and the complexity inherent in clinical decisions will facilitate a more complete unde...
Source: Medical Decision Making - May 5, 2015 Category: Health Management Authors: Dalton, A. F., Golin, C. E., Esserman, D., Pignone, M. P., Pathman, D. E., Lewis, C. L. Tags: Original Articles Source Type: research
