Probabilistic sensitivity analysis for NICE technology assessment: not an optional extra
Probabilistic sensitivity analysis for NICE technology assessment: not an optional extra
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DOI：
10.1002/hec.985
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发表时间：
2005-04-01
期刊：
影响因子：
2.1
通讯作者：
O'Hagan, T
中科院分区：
文献类型：
--
作者：
Claxton, K;Sculpher, M;O'Hagan, T
最近，国家临床卓越研究所(NICE)更新了其技术评估方法指南。新指南的一个方面是要求对提交研究所的所有成本效益模型进行概率敏感性分析。本文件的目的是将关于处理不确定性的良好指导意见放在更广泛的决策要求的背景下；解释在制定该指导意见时采取的一般方法；并讨论在关于概率敏感性分析的一般作用的辩论中提出的每一个问题。制定指南的最合适起点是确定决策所需的内容。在这些要求的基础上，可以确定最能满足这些需要的分析方法和框架。有人会争辩说，关于处理不确定性的指导意见，特别是关于概率敏感度分析的要求，是根据NICE被要求作出的决定类型的要求而提出的。在此基础上，对在咨询过程中和之后提出的主要问题和批评进行了审查。最后，将确定和讨论由于需要充分描述决策不确定性并为研究议程提供信息而带来的一些方法学挑战。版权所有(C)2005 John Wiley&Sons，Ltd.
Recently the National Institute for Clinical Excellence (NICE) updated its methods guidance for technology assessment. One aspect of the new guidance is to require the use of probabilistic sensitivity analysis with all cost-effectiveness models submitted to the Institute. The purpose of this paper is to place the NICE guidance on dealing with uncertainty into a broader context of the requirements for decision making; to explain the general approach that was taken in its development; and to address each of the issues which have been raised in the debate about the role of probabilistic sensitivity analysis in general. The most appropriate starting point for developing guidance is to establish what is required for decision making. On the basis of these requirements, the methods and framework of analysis which can best meet these needs can then be identified. It will be argued that the guidance on dealing with uncertainty and, in particular, the requirement for probabilistic sensitivity analysis, is justified by the requirements of the type of decisions that NICE is asked to make. Given this foundation, the main issues and criticisms raised during and after the consultation process are reviewed. Finally, some of the methodological challenges posed by the need fully to characterise decision uncertainty and to inform the research agenda will be identified and discussed. Copyright (c) 2005 John Wiley & Sons, Ltd.