Decision models until assessment of health impact

decision model

developed to assist decision-makers in making choices relating to the evaluated options

incremental costs

The objective of a decision model is to obtain a clearer understanding of the relationships between ______ and their consequences.

decision model

should mimic the patients’ evolution from the current status of health to the final one (cured or death). It should simulate as much as possible the real life setting of the disease

• decision trees

• Markov models (state-transition model)

• dynamic transmission model

3 common structures used in economic evaluations

decision tree

• form of analytical model in which distinct branches are used to represent a potential set of outcomes for a patient or patient cohort

• used to model interventions that have few and distinct outcomes that can be measured at a specific time point or over short time horizons

Markov model (state- transition model)

• For more complex frameworks involving stochastic processes

• model well-suited for chronic conditions

• uses disease states to represent all possible consequences of an intervention of interest.

dynamic transmission model / dynamic model

• analysis of interventions against an infectious disease concerning the population of interest

• This type of modelling incorporates externalities such as indirect effects from averted infections due to vaccination

dependent

In a dynamic model, the infection risk is _____ on the number of infectious agents at a given point in time.

Model validation

important to see how accurate a model can make relevant predictions

• Face validation

• Internal validation or Technical validation / Verification

• Cross validation / Convergent validation / Model corroboration

• External validation

• Predictive validation

5 main types of validation based on the Good Modeling Practices

International Society for Pharmacoeconomics and Outcomes Research

ISPOR stands for?

Face validation

type of validation where validation of the model, its assumptions, and applications as judged by experts relevant to the problem area; this may be done by conducting a stakeholder consultation

Internal validation / Technical validation or Verification

type of validation where examination of the mathematical calculations performed through the verification of individual equations and their accurate implementation in code

Cross validation / Convergent validation / Model corroboration

type of validation where comparison with other models and determination of the extent to which they calculate similar or different results

External validation

type of validation where simulation of a real scenario (e.g., clinical trial) and comparison of the predicted outcomes to the real-world outcomes

Predictive validation

type of validation where comparison of forecasted outcomes with actual events

predictive validation

most desirable type of validation but time-consuming and therefore not recommended for immediate decisions

Incremental cost-effectiveness ratio (ICER)

result of the cost-effectiveness or cost-utility analysis is best summarized in the form of an _______

Incremental cost-effectiveness ratio (ICER)

a value defined as the difference in cost between two interventions, divided by the difference in health outcome obtained

Incremental cost-effectiveness ratio (ICER)

additional cost per additional benefit delivered by the new technology compared to the old technology

ethical, legal, and social implications (ELSI)

HTA takes into account the ______ associated with the use or non-use of a health technology

interactive, participatory approach

An _______ involving relevant stakeholders in a real discourse (through a consultation) should be done to improve the applicability of the HTA.

Equity

implies in health that ideally, everyone should have a fair opportunity to attain their full health potential, and that no one should be disadvantaged from achieving this potential

Qualitative methods

ay be employed in assessing the equity implications of a proposed intervention because they are effective in identifying factors and contexts that affect access to or quality of care received.

• participant observation

• in-depth interviews

• focus group discussions

• online ethnography

4 most common qualitative methods

PROGRESS-Plus

The report on equity shall be organized according to _______

PROGRESS-Plus

• acronym developed by Cochrane

• may also be used to further define factors that stratify health opportunities and outcomes

EUnetHTA (Annex 13)

the ELSI checklist developed by ______ may be used as one of the tools to assess and report the ethical, legal, and social issues surrounding the implementation of a proposed health technology