Journal
MEDICAL DECISION MAKING
Volume 33, Issue 3, Pages 415-436Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0272989X12451058
Keywords
Markov model; elicited evidence; pilot trial; negative pressure wound therapy; sparse; evidence synthesis; expected value of information; research design; cost-effectiveness analysis
Funding
- Medical Research Council [G0501814]
- MRC [G0501814, G0501892] Funding Source: UKRI
- Medical Research Council [G0501814, G0501892] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10028] Funding Source: researchfish
Ask authors/readers for more resources
Health care resources are scarce, and decisions have to be made about how to allocate funds. Often, these decisions are based on sparse or imperfect evidence. One such example is negative-pressure wound therapy (NPWT), which is a widely used treatment for severe pressure ulcers; however, there is currently no robust evidence that it is effective or cost-effective. This work considers the decision to adopt NPWT given a range of alternative treatments, using a decision analytic modeling approach. Literature searches were conducted to identify existing evidence on model parameters. Given the limited evidence base, a second source of evidence, beliefs elicited from experts, was used. Judgments from experts on relevant (uncertain) quantities were obtained through a formal elicitation exercise. Additionally, data derived from a pilot trial were also used to inform the model. The 3 sources of evidence were collated, and the impact of each on cost-effectiveness was evaluated. An analysis of the value of further information indicated that a randomized controlled trial may be worthwhile in reducing decision uncertainty, where from a set of alternative designs, a 3-arm trial with longer follow-up was estimated to be the most efficient. The analyses presented demonstrate how allocation decisions about medical technologies can be explicitly informed when data are sparse and how this kind of analyses can be used to guide future research prioritization, not only indicating whether further research is worthwhile but what type of research is needed and how it should be designed.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available