Bayesian models for cost-effectiveness analysis in the presence of structural zero costs
Bayesian models for cost-effectiveness analysis in the presence of structural zero costs
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DOI：
10.1002/sim.6074
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发表时间：
2014-05-20
影响因子：
2
通讯作者：
Baio, Gianluca
中科院分区：
文献类型：
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作者：
Baio, Gianluca
近年来，成本效益数据的贝叶斯模型在卫生经济学和统计文献中受到了广泛关注。成本效益数据的特点是相对复杂的关系结构，将临床效益的适当衡量标准（例如质量调整生命年）与相关成本联系起来。通常不认可简化假设，例如基础分布的（双变量）正态性，特别是对于成本变量，其特征是分布明显偏斜。此外，个人层面的数据集通常以成本变量中存在结构性零为特征。障碍模型可用于解释分布中是否存在多余的零，并已应用于成本数据的背景中。我们将其应用扩展到成本效益数据，定义了完整的贝叶斯规范，其中包括零成本个体概率模型、成本边际模型和有效性度量条件模型（给定观察到的成本）。我们使用一个工作示例来介绍该模型来描述其主要特征。 (c) 2013 年作者。 John Wiley & Sons, Ltd. 出版的《医学统计》
Bayesian modelling for cost-effectiveness data has received much attention in both the health economics and the statistical literature, in recent years. Cost-effectiveness data are characterised by a relatively complex structure of relationships linking a suitable measure of clinical benefit (e.g. quality-adjusted life years) and the associated costs. Simplifying assumptions, such as (bivariate) normality of the underlying distributions, are usually not granted, particularly for the cost variable, which is characterised by markedly skewed distributions. In addition, individual-level data sets are often characterised by the presence of structural zeros in the cost variable. Hurdle models can be used to account for the presence of excess zeros in a distribution and have been applied in the context of cost data. We extend their application to cost-effectiveness data, defining a full Bayesian specification, which consists of a model for the individual probability of null costs, a marginal model for the costs and a conditional model for the measure of effectiveness (given the observed costs). We presented the model using a working example to describe its main features. (c) 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.