Exploring uncertainty in cost-effectiveness analysis
Exploring uncertainty in cost-effectiveness analysis
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DOI：
10.2165/00019053-200826090-00008
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发表时间：
2008-01-01
影响因子：
4.4
通讯作者：
Claxton, Karl
中科院分区：
文献类型：
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作者：
Claxton, Karl
本文介绍了为什么不确定性及其后果的评估是至关重要的决定，如英国国家卫生与临床卓越研究所（NICE）的机构类型的关键原则。在这样做的时候，它提出了一个问题，正式的方法是否可能是有用的NICE及其咨询委员会在作出这样的评估。概括地说，这些问题包括：（一）是否应继续建议将概率敏感性分析作为表征参数不确定性的一种手段;（二）应使用哪些方法来表示其他不确定性来源;（三）何时可以证明计算费用昂贵的模型是合理的，计算费用是否足以证明不表示不确定性;（iv）应采用哪种概括的不确定性量度方法向决策者提供结果;及（v）是否应建议采用正式方法，以评估英国国民保健制度对证据的需要，以及不确定性决定的后果？
This paper describes the key principles of why an assessment of uncertainty and its consequences are critical for the types of decisions that a body such as the UK National Institute for Health and Clinical Excellence (NICE) has to make. In doing so, it poses the question of whether formal methods may be useful to NICE and its advisory committees in making such assessments. Broadly, these include the following: (i) should probabilistic sensitivity analysis continue to be recommended as a means to characterize parameter uncertainty; (ii) which methods should be used to represent other sources of uncertainty; (iii) when can computationally expensive models be justified and is computation expense a sufficient justification for failing to express uncertainty; (iv) which summary measures of uncertainty should be used to present the results to decision makers; and (v) should formal methods be recommended to inform the assessment of the need for evidence and the consequences of an uncertain decision for the UK NHS?.