O'Brien, B.J. and Briggs, A.H. (2002) Analysis of uncertainty in health care cost-effectiveness studies: an introduction to statistical issues and methods. Statistical Methods in Medical Research, 11(6), pp. 455-468. (doi: 10.1191/0962280202sm304ra)
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Publisher's URL: http://dx.doi.org/10.1191/0962280202sm304ra
Abstract
Cost-effectiveness analysis is now an integral part of health technology assessment and addresses the question of whether a new treatment or other health care program offers good value for money. In this paper we introduce the basic framework for decision making with cost-effectiveness data and then review recent developments in statistical methods for analysis of uncertainty when cost-effectiveness estimates are based on observed data from a clinical trial. Although much research has focused on methods for calculating confidence intervals for cost-effectiveness ratios using bootstrapping or Fieller’s method, these calculations can be problematic with a ratio-based statistic where numerator and=or denominator can be zero. We advocate plotting the joint density of cost and effect differences, together with cumulative density plots known as cost-effectiveness acceptability curves (CEACs) to summarize the overall value-for-money of interventions. We also outline the net-benefit formulation of the cost-effectiveness problem and show that it has particular advantages over the standard incremental cost-effectiveness ratio formulation.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Briggs, Professor Andrew |
Authors: | O'Brien, B.J., and Briggs, A.H. |
Subjects: | R Medicine > RA Public aspects of medicine H Social Sciences > HJ Public Finance |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment College of Medical Veterinary and Life Sciences |
Journal Name: | Statistical Methods in Medical Research |
Publisher: | SAGE |
ISSN: | 0962-2802 |
ISSN (Online): | 1477-0334 |
Copyright Holders: | Copyright © 2002 SAGE |
First Published: | First published in Statistical Methods in Medical Research 11(6):455-468 |
Publisher Policy: | Reproduced in accordance with the copyright policy of the publisher |
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