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Employing early decision analytic modelling to inform economic evaluation in health care: theory & practice

Boyd, Kathleen Anne (2012) Employing early decision analytic modelling to inform economic evaluation in health care: theory & practice. PhD thesis, University of Glasgow.

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Abstract

Decision analytic modelling (DAM) is a mathematical technique which is used to structure and synthesise evidence in order to inform decision making, given uncertainty. Decision models are an ideal tool for undertaking economic evaluations as they enable a wide range of data on costs and effects to be synthesised within the model in order to derive cost-effectiveness outcomes. The iterative framework for economic appraisal has been proposed as good practice for undertaking economic evaluations (1), and DAM plays a key role within this framework. In particular there is a role for early stage DAM prior to primary research, to provide an indication of the potential cost-effectiveness of a new health technology (2) given current evidence, and the use of value of information (VOI) techniques to help inform further research priority setting. In practice, support and funding for early stage DAM and full exploitation of VOI techniques is rare. The aim of this thesis is to examine the role for early decision analytic modelling in informing research priorities and the design of future studies in a health care setting. This thesis explores the feasibility, merits and drawbacks of undertaking early DAM and considers potential reasons as to why it has not been more widely implemented. This thesis demonstrates the value and importance of early DAM; in both an ‘ideal’ setting and also in a less desirable, time-constrained setting. Applying early DAM and VOI techniques enables researchers to provide relevant conclusions and recommendations to decision makers, who can make informed decisions as to whether a new intervention should be adopted (or rejected), or whether further information is required to help make the decision; as opposed to making decisions based on subjective reasoning. There is considerable merit with employing early DAM for health care research, such as reduced uncertainty, reduction of costs and efficiency gains, however, some drawbacks exist in terms of whether it is always viable to fully exploit VOI analyses, which may hinder widespread support both inside and out-with the health economics community.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: Economic evaluation, decision analytic modelling, value of information, cost-effectiveness analysis
Subjects: R Medicine > R Medicine (General)
H Social Sciences > HB Economic Theory
Colleges/Schools: College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing
Supervisor's Name: Briggs, Prof. Andrew and Fenwick, Dr. Elisabeth
Date of Award: 2012
Depositing User: Mrs Kathleen Anne Boyd
Unique ID: glathesis:2012-3685
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 26 Oct 2012
Last Modified: 10 Dec 2012 14:09
URI: http://theses.gla.ac.uk/id/eprint/3685

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