Valuing Health-Related Quality of Life in Type 2 Diabetes Patients in China
Conclusion. The HSU values estimated can be used to assess the cost-effectiveness of health care interventions for T2D patients in China. (Source: Medical Decision Making)
Source: Medical Decision Making - December 30, 2015 Category: Health Management Authors: Pan, C.-W., Sun, H.-P., Zhou, H.-J., Ma, Q., Xu, Y., Luo, N., Wang, P. Tags: Original Articles Source Type: research
Quantifying Parameter Uncertainty in EQ-5D-3L Value Sets and Its Impact on Studies That Use the EQ-5D-3L to Measure Health Utility: A Bayesian Approach
Conclusion. EQ-5D-3L value sets are estimated subject to considerable parameter uncertainty; the median credible interval width is large compared with reported values of the minimum important difference for the EQ-5D-3L, which have been reported to be as small as 0.03. Other countries’ scoring algorithms are based on smaller studies and are hence subject to greater uncertainty. This uncertainty should be accounted for when using EQ-5D health utilities in economic evaluations. (Source: Medical Decision Making)
Source: Medical Decision Making - December 30, 2015 Category: Health Management Authors: Pullenayegum, E. M., Chan, K. K. W., Xie, F. Tags: Original Articles Source Type: research
Eliciting Societal Preferences for Weighting QALYs for Burden of Illness and End of Life
Conclusions. The social value of a QALY gain is not equal between recipients but depends on whether they are end of life, and it may depend on the prospective burden of illness. (Source: Medical Decision Making)
Source: Medical Decision Making - December 30, 2015 Category: Health Management Authors: Rowen, D., Brazier, J., Mukuria, C., Keetharuth, A., Risa Hole, A., Tsuchiya, A., Whyte, S., Shackley, P. Tags: Original Articles Source Type: research
Valuation of Child Behavioral Problems from the Perspective of US Adults
Conclusions. The findings are the first to produce a preference-based summary measure of child behavioral problems on a QALY scale. The results may inform both clinical practice and resource allocation decisions by enhancing our understanding of difficult tradeoffs in how adults view child behavioral problems. Understanding US values also promotes national health surveillance by complementing conventional measures of surveillance, survival, and diagnoses. (Source: Medical Decision Making)
Source: Medical Decision Making - December 30, 2015 Category: Health Management Authors: Craig, B. M., Brown, D. S., Reeve, B. B. Tags: Original Articles Source Type: research
Altruistic Preferences in Time Tradeoff: Consideration of Effects on Others in Health State Valuations
We present an extended quality-adjusted life-year model incorporating altruism. We derive that altruism may affect TTO values in 2 directions. First, "longevity altruists" may wish to prolong life for the sake of their loved ones (to avoid being missed). Second, "quality-of-life altruists" may have a preference to avoid bad health states resulting in being a burden to loved ones. The existence and influence of these preferences in a TTO were empirically confirmed in a sample of 1690 respondents from the general public. We classified respondents as "longevity altruists" or "quality-of-life altruists" based on their reasonin...
Source: Medical Decision Making - December 30, 2015 Category: Health Management Authors: Krol, M., Attema, A. E., van Exel, J., Brouwer, W. Tags: Original Articles Source Type: research
A Framework for Including Family Health Spillovers in Economic Evaluation
Health care interventions may affect the health of patients’ family networks. It has been suggested that these "health spillovers" should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the "health care perspective"). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover...
Source: Medical Decision Making - December 30, 2015 Category: Health Management Authors: Al-Janabi, H., van Exel, J., Brouwer, W., Coast, J. Tags: Original Articles Source Type: research
Mapping between 6 Multiattribute Utility Instruments
Conclusion: Transformations presented here align the measurement scales of MAU instruments. Their use will increase confidence in the comparability of evaluation studies, which have employed different MAU instruments. (Source: Medical Decision Making)
Source: Medical Decision Making - December 30, 2015 Category: Health Management Authors: Chen, G., Khan, M. A., Iezzi, A., Ratcliffe, J., Richardson, J. Tags: Original Articles Source Type: research
Measuring the Sensitivity and Construct Validity of 6 Utility Instruments in 7 Disease Areas
Background. Health services that affect quality of life (QoL) are increasingly evaluated using cost utility analyses (CUA). These commonly employ one of a small number of multiattribute utility instruments (MAUI) to assess the effects of the health service on utility. However, the MAUI differ significantly, and the choice of instrument may alter the outcome of an evaluation. Aims. The present article has 2 objectives: 1) to compare the results of 3 measures of the sensitivity of 6 MAUI and the results of 6 tests of construct validity in 7 disease areas and 2) to rank the MAUI by each of the test results in each disease are...
Source: Medical Decision Making - December 30, 2015 Category: Health Management Authors: Richardson, J., Iezzi, A., Khan, M. A., Chen, G., Maxwell, A. Tags: Original Articles Source Type: research
The Impact of Oversampling with SMOTE on the Performance of 3 Classifiers in Prediction of Type 2 Diabetes
Conclusions. To determine a classifier with a machine learning algorithm like the PNN and DT, class skew in data should be considered. The NB and DT were optimal classifiers in a prediction task in an imbalanced medical database. (Source: Medical Decision Making)
Source: Medical Decision Making - December 15, 2015 Category: Health Management Authors: Ramezankhani, A., Pournik, O., Shahrabi, J., Azizi, F., Hadaegh, F., Khalili, D. Tags: Technical Note Source Type: research
An Efficient, Noniterative Method of Identifying the Cost-Effectiveness Frontier
Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that chal...
Source: Medical Decision Making - December 15, 2015 Category: Health Management Authors: Suen, S.-c., Goldhaber-Fiebert, J. D. Tags: Brief Report Source Type: research
Theoretical Foundations and Practical Applications of Within-Cycle Correction Methods
Conclusion. Cumulative outcomes in DTSTMs are prone to errors that can be reduced with more accurate methods like Simpson’s rules. We clarified several misconceptions and provided recommendations and algorithms for practical implementation of these methods. (Source: Medical Decision Making)
Source: Medical Decision Making - December 15, 2015 Category: Health Management Authors: Elbasha, E. H., Chhatwal, J. Tags: Original Articles Source Type: research
Empirical Treatment Effectiveness Models for Binary Outcomes
Randomized trials provide strong evidence regarding efficacy of interventions but are limited in their capacity to address potential heterogeneity in effectiveness within broad clinical populations. For example, a treatment that on average is superior may be distinctly worse in certain patients. We propose a technique for using large electronic health registries to develop and validate decision models that measure—for distinct combinations of covariate values—the difference in predicted outcomes among 2 alternative treatments. We demonstrate the methodology in a prototype analysis of in-hospital mortality under...
Source: Medical Decision Making - December 15, 2015 Category: Health Management Authors: Dalton, J. E., Dawson, N. V., Sessler, D. I., Schold, J. D., Love, T. E., Kattan, M. W. Tags: Original Articles Source Type: research
Multistate Statistical Modeling: A Tool to Build a Lung Cancer Microsimulation Model That Includes Parameter Uncertainty and Patient Heterogeneity
In this study, we used multistate statistical modeling to inform a microsimulation model for cost-effectiveness analysis of individualized radiotherapy in lung cancer. The model tracks clinical events over time and takes patient and tumor features into account. Four clinical states were included in the model: alive without progression, local recurrence, metastasis, and death. Individual patients were simulated by repeatedly sampling a patient profile, consisting of patient and tumor characteristics. The transitioning of patients between the health states is governed by personalized time-dependent hazard rates, which were o...
Source: Medical Decision Making - December 15, 2015 Category: Health Management Authors: Bongers, M. L., de Ruysscher, D., Oberije, C., Lambin, P., Uyl-de Groot, C. A., Coupe, V. M. H. Tags: Original Articles Source Type: research
Expansion of the National Salt Reduction Initiative: A Mathematical Model of Benefits and Risks of Population-Level Sodium Reduction
Conclusions: An expanded National Salt Reduction Initiative is likely to significantly reduce hypertension and hypertension-related cardiovascular morbidity but may be accompanied by potential risks to older women. (Source: Medical Decision Making)
Source: Medical Decision Making - December 15, 2015 Category: Health Management Authors: Choi, S. E., Brandeau, M. L., Basu, S. Tags: Original Articles Source Type: research
Continuous-Time Semi-Markov Models in Health Economic Decision Making: An Illustrative Example in Heart Failure Disease Management
Continuous-time state transition models may end up having large unwieldy structures when trying to represent all relevant stages of clinical disease processes by means of a standard Markov model. In such situations, a more parsimonious, and therefore easier-to-grasp, model of a patient’s disease progression can often be obtained by assuming that the future state transitions do not depend only on the present state (Markov assumption) but also on the past through time since entry in the present state. Despite that these so-called semi-Markov models are still relatively straightforward to specify and implement, they are...
Source: Medical Decision Making - December 15, 2015 Category: Health Management Authors: Cao, Q., Buskens, E., Feenstra, T., Jaarsma, T., Hillege, H., Postmus, D. Tags: Original Articles Source Type: research
