Graphical Probabilistic Models for Risk Prediction and Decision Making Using Real-World Data: A Developing Tool for the Era of Precision Medicine

Dj Boyne
Dj Boyne
Mj Druzdzel
Mj Druzdzel

Value in Health, 2018.

Cited by: 0|Bibtex|Views20|
Keywords:
graphical probabilisticHuman Immunodeficiency Virusprogression-free survivalcost effectiveness analysisBudget impact analysisMore(13+)
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This study aims to perform a cost-effectiveness analysis of a universal versus targeted Human Immunodeficiency Virus screening approach to identify new Human Immunodeficiency Virus diagnoses in the Emergency Department setting

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Introduction
  • This study aims to perform a cost-effectiveness analysis of a universal versus targeted HIV screening approach to identify new HIV diagnoses in the ED setting.
  • Methods: A decision tree was developed using TreeAge Pro to compare the cost-effectiveness ratios of universal vs targeted screening for detecting new HIV positive patients.
Highlights
  • This study aims to perform a cost-effectiveness analysis of a universal versus targeted Human Immunodeficiency Virus screening approach to identify new Human Immunodeficiency Virus diagnoses in the Emergency Department setting
  • The incremental cost effectiveness ratio was estimated at 17,759, which represents the cost required to identify one additional case of Human Immunodeficiency Virus in the universal screening approach compared to the targeted approach
  • The social impact inventory of the second Cost-Effectiveness Panel is a special, restricted case of this more general approach Conclusions: Through appropriate assessment of the evidence and by clearly distinguishing the points at which value judgements feed into the evaluation process, assessments of interventions with multiple outcomes and costs falling across different sectors can reliably be informed
  • Approach: We introduce BNs, key theoretical concepts around graphical probabilistic models and our review of the literature on the applications of such models to real-world problems for medical interventions, causal reasoning under uncertainty for decision models and risk prediction
Results
  • The ICER was estimated at 17,759, which represents the cost required to identify one additional case of HIV in the universal screening approach compared to the targeted approach.
  • Conclusions: the incremental cost of identifying a new HIV case is higher when using a universal screening approach.
  • The approach provides information on cost-effectiveness from a range of perspectives, and facilitates deliberation between different decision makers when there are conflicting objectives by making the trade-offs and value judgements explicit.
  • The social impact inventory of the second Cost-Effectiveness Panel is a special, restricted case of this more general approach Conclusions: Through appropriate assessment of the evidence and by clearly distinguishing the points at which value judgements feed into the evaluation process, assessments of interventions with multiple outcomes and costs falling across different sectors can reliably be informed.
  • The authors compare these approaches using hypothetical examples, explore their underlying assumptions, outline the analytical steps involved, and discuss their potential advantages for ITCs. The authors aim to provide researchers and decision makers with context to address questions such as, when such methods should be considered, and under what conditions are they appropriate and should be used.
  • Conclusions: Accounting for ATB could add valuable insight into the comparative assessment of PFS, can minimize bias, provide a helpful addition to the analyses of data from IO clinical trials and inform clinical decision making.
  • CP4 Budget Impact Analysis with Simultaneous Multiple Market Entrants: Static Versus Dynamic Baseline Market Shares O’Day K, Meyer K Xcenda, Palm Harbor, FL, USA Objective: Budget impact analysis (BIA) quantifies the potential incremental costs of new health technologies for health care payers.
  • To present a method for using dynamic baseline market shares to estimate the budget impact of a single product when there are multiple market entrants.
Conclusion
  • To estimate the budget impact of a single product among simultaneous multiple market entrants requires that future market share projections for all products minus the product of interest be included in a dynamic baseline.
  • Conclusion: A BIA with dynamic, instead of static, baseline market shares provides a method to estimate the budget impact for single new products when there are simultaneous multiple market entrants.
Summary
  • This study aims to perform a cost-effectiveness analysis of a universal versus targeted HIV screening approach to identify new HIV diagnoses in the ED setting.
  • Methods: A decision tree was developed using TreeAge Pro to compare the cost-effectiveness ratios of universal vs targeted screening for detecting new HIV positive patients.
  • The ICER was estimated at 17,759, which represents the cost required to identify one additional case of HIV in the universal screening approach compared to the targeted approach.
  • Conclusions: the incremental cost of identifying a new HIV case is higher when using a universal screening approach.
  • The approach provides information on cost-effectiveness from a range of perspectives, and facilitates deliberation between different decision makers when there are conflicting objectives by making the trade-offs and value judgements explicit.
  • The social impact inventory of the second Cost-Effectiveness Panel is a special, restricted case of this more general approach Conclusions: Through appropriate assessment of the evidence and by clearly distinguishing the points at which value judgements feed into the evaluation process, assessments of interventions with multiple outcomes and costs falling across different sectors can reliably be informed.
  • The authors compare these approaches using hypothetical examples, explore their underlying assumptions, outline the analytical steps involved, and discuss their potential advantages for ITCs. The authors aim to provide researchers and decision makers with context to address questions such as, when such methods should be considered, and under what conditions are they appropriate and should be used.
  • Conclusions: Accounting for ATB could add valuable insight into the comparative assessment of PFS, can minimize bias, provide a helpful addition to the analyses of data from IO clinical trials and inform clinical decision making.
  • CP4 Budget Impact Analysis with Simultaneous Multiple Market Entrants: Static Versus Dynamic Baseline Market Shares O’Day K, Meyer K Xcenda, Palm Harbor, FL, USA Objective: Budget impact analysis (BIA) quantifies the potential incremental costs of new health technologies for health care payers.
  • To present a method for using dynamic baseline market shares to estimate the budget impact of a single product when there are multiple market entrants.
  • To estimate the budget impact of a single product among simultaneous multiple market entrants requires that future market share projections for all products minus the product of interest be included in a dynamic baseline.
  • Conclusion: A BIA with dynamic, instead of static, baseline market shares provides a method to estimate the budget impact for single new products when there are simultaneous multiple market entrants.
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