Numbers Matter to Informed Patient Choices: A Randomized Design across Age and Numeracy Levels
Conclusions. Providing numeric AE-likelihood information (compared with nonnumeric) is likely to increase risk comprehension across numeracy and age levels. Its effects on uptake and adherence of prescribed drugs should be similar across the population, except perhaps in older, less numerate individuals. (Source: Medical Decision Making)
Source: Medical Decision Making - April 16, 2014 Category: Health Management Authors: Peters, E., Hart, P. S., Tusler, M., Fraenkel, L. Tags: Original Articles Source Type: research
Decisive Evidence on a Smaller-Than-You-Think Phenomenon: Revisiting the "1-in-X" Effect on Subjective Medical Probabilities
Accurate perception of medical probabilities communicated to patients is a cornerstone of informed decision making. People, however, are prone to biases in probability perception. Recently, Pighin and others extended the list of such biases with evidence that "1-in-X" ratios (e.g., "1 in 12") led to greater perceived probability and worry about health outcomes than "N-in-X*N" ratios (e.g., "10 in 120"). Subsequently, the recommendation was to avoid using "1-in-X" ratios when communicating probabilistic information to patients. To warrant such a recommendation, we conducted 5 well-powered replications and synthesized the av...
Source: Medical Decision Making - April 16, 2014 Category: Health Management Authors: Sirota, M., Juanchich, M., Kostopoulou, O., Hanak, R. Tags: Original Articles Source Type: research
In Memoriam: Jane Carrie Weeks, MD, MSc--Decision Scientist, Outcomes Researcher, Teacher, and Friend
(Source: Medical Decision Making)
Source: Medical Decision Making - April 16, 2014 Category: Health Management Authors: Weinstein, M. C. Tags: Editorials Source Type: research
From Text Tagging to Decision Support
(Source: Medical Decision Making)
Source: Medical Decision Making - April 16, 2014 Category: Health Management Authors: Lehmann, H. P. Tags: Editorials Source Type: research
Continued Use of 1-in-X Risk Communications Is a Systemic Problem
(Source: Medical Decision Making)
Source: Medical Decision Making - April 16, 2014 Category: Health Management Authors: Zikmund-Fisher, B. J. Tags: Editorials Source Type: research
The Use of z Scores in Probabilistic Sensitivity Analyses
(Source: Medical Decision Making)
Source: Medical Decision Making - March 31, 2014 Category: Health Management Authors: Schauer, D. P., Eckman, M. H. Tags: Technical Note Source Type: research
Adjusting Survival Time Estimates to Account for Treatment Switching in Randomized Controlled Trials--an Economic Evaluation Context: Methods, Limitations, and Recommendations
Conclusions. The limitations associated with switching adjustment methods such as the RPSFTM and IPCW mean that they are appropriate in different scenarios. In some scenarios, both methods may be prone to bias; "2-stage" methods should be considered, and intention-to-treat analyses may sometimes produce the least bias. The data requirements of adjustment methods also have important implications for clinical trialists. (Source: Medical Decision Making)
Source: Medical Decision Making - March 31, 2014 Category: Health Management Authors: Latimer, N. R., Abrams, K. R., Lambert, P. C., Crowther, M. J., Wailoo, A. J., Morden, J. P., Akehurst, R. L., Campbell, M. J. Tags: Original Articles Source Type: research
Cost-Effectiveness on a Local Level: Whether and When to Adopt a New Technology
Cost-effectiveness analysis has become a widely accepted tool for decision making in health care. The standard textbook cost-effectiveness analysis focuses on whether to make the switch from an old or common practice technology to an innovative technology, and in doing so, it takes a global perspective. In this article, we are interested in a local perspective, and we look at the questions of whether and when the switch from old to new should be made. A new approach to cost-effectiveness from a local (e.g., a hospital) perspective, by means of a mathematical model for cost-effectiveness that explicitly incorporates time, i...
Source: Medical Decision Making - March 31, 2014 Category: Health Management Authors: Woertman, W. H., Van De Wetering, G., Adang, E. M. M. Tags: Original Articles Source Type: research
Health Care Costs for State Transition Models in Prostate Cancer
Conclusions . This study used an innovative but labor-intensive approach linking chart and administrative data to estimate health care costs. Researchers should weigh the potential benefits of this method against what is involved in implementation. Modifications in methodology may achieve similar gains with less outlay in individual studies. However, we believe that this is a promising approach for researchers wishing to advance the quality of costing in state transition modeling. (Source: Medical Decision Making)
Source: Medical Decision Making - March 31, 2014 Category: Health Management Authors: Krahn, M. D., Bremner, K. E., Zagorski, B., Alibhai, S. M. H., Chen, W., Tomlinson, G., Mitsakakis, N., Naglie, G. Tags: Original Articles Source Type: research
Expected Value of Sample Information for Multi-Arm Cluster Randomized Trials with Binary Outcomes
Expected value of sample information (EVSI) measures the anticipated net benefit gained from conducting new research with a specific design to add to the evidence on which reimbursement decisions are made. Cluster randomized trials raise specific issues for EVSI calculations because 1) a hierarchical model is necessary to account for between-cluster variability when incorporating new evidence and 2) heterogeneity between clusters needs to be carefully characterized in the cost-effectiveness analysis model. Multi-arm trials provide parameter estimates that are correlated, which needs to be accounted for in EVSI calculations...
Source: Medical Decision Making - March 31, 2014 Category: Health Management Authors: Welton, N. J., Madan, J. J., Caldwell, D. M., Peters, T. J., Ades, A. E. Tags: Original Articles Source Type: research
Survival Analysis and Extrapolation Modeling of Time-to-Event Clinical Trial Data for Economic Evaluation: An Alternative Approach
This article examines the proposed algorithm and highlights various shortcomings that involve questionable assumptions, including researchers’ access to patient-level data, the relevance of proportional hazards modeling, and the appropriateness of standard probability functions for characterizing risk, which may mislead practitioners into employing biased structures for projecting limited data in decision models. An alternative paradigm is outlined. This paradigm is based on the primacy of the experimental data and adherence to the scientific method through hypothesis formulation and validation. Drawing on extensive ...
Source: Medical Decision Making - March 31, 2014 Category: Health Management Authors: Bagust, A., Beale, S. Tags: Original Articles Source Type: research
Strategies for Efficient Computation of the Expected Value of Partial Perfect Information
Expected value of information methods evaluate the potential health benefits that can be obtained from conducting new research to reduce uncertainty in the parameters of a cost-effectiveness analysis model, hence reducing decision uncertainty. Expected value of partial perfect information (EVPPI) provides an upper limit to the health gains that can be obtained from conducting a new study on a subset of parameters in the cost-effectiveness analysis and can therefore be used as a sensitivity analysis to identify parameters that most contribute to decision uncertainty and to help guide decisions around which types of study ar...
Source: Medical Decision Making - March 31, 2014 Category: Health Management Authors: Madan, J., Ades, A. E., Price, M., Maitland, K., Jemutai, J., Revill, P., Welton, N. J. Tags: Original Articles Source Type: research
Estimating Multiparameter Partial Expected Value of Perfect Information from a Probabilistic Sensitivity Analysis Sample: A Nonparametric Regression Approach
We describe a novel nonparametric regression-based method for estimating partial EVPI 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 is applicable in a model of any complexity and with any specification of input parameter distribution. We describe the implementation of the method via 2 nonparametric regression modeling approaches, the Generalized Additive Model and the Gaussian process. We demonstrate in 2 case studies the superior efficiency of the regression method over the 2-lev...
Source: Medical Decision Making - March 31, 2014 Category: Health Management Authors: Strong, M., Oakley, J. E., Brennan, A. Tags: Original Articles Source Type: research
Assessing Uncertainties Surrounding Combined Endpoints for Use in Economic Models
Conclusions: The logistic approaches offer a flexible way to reflect one’s beliefs about the interrelationships between individual endpoints, potentially decreasing uncertainty margins. The approach works equally well with and without data concerning the underlying disease process. (Source: Medical Decision Making)
Source: Medical Decision Making - March 31, 2014 Category: Health Management Authors: Heeg, B. M., van Hout, B. A. Tags: Original Articles Source Type: research
Appropriate Evidence Sources for Populating Decision Analytic Models within Health Technology Assessment (HTA): A Systematic Review of HTA Manuals and Health Economic Guidelines
Conclusions. The usability of guidelines and manuals for modeling could be improved by addressing the issue of evidence sources in a more structured and comprehensive format. (Source: Medical Decision Making)
Source: Medical Decision Making - March 31, 2014 Category: Health Management Authors: Zechmeister-Koss, I., Schnell-Inderst, P., Zauner, G. Tags: Review Source Type: research
