Anna Heath, Gianluca Baio, Ioanna Manolopoulou, Nicky J. Welton
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引用次数: 0
摘要
信息价值(VOI)分析计算的是通过获取更多信息以减少健康经济决策模型中的不确定性而产生的经济价值。VOI 被建议作为研究优先次序和试验设计的工具,因为它可以突出未来研究的经济价值途径。近期方法学上的进步使得在研究实践中使用 VOI 变得越来越可行;然而,VOI 方法与用于设计研究(如临床试验)的标准方法之间存在重大差异。我们的目的是强调基于自愿自主创新的研究设计方法与标准临床试验设计方法之间的主要区别,特别是考虑整个决策背景的重要性。我们举了两个假设的例子来说明,只有在以下情况下,VOI 方法才是准确的:(1) 在设计研究时,将所有可行的比较对象都纳入决策模型;(2) 在收集数据并提出最终治疗建议后,将所有比较对象都保留在决策模型中。使用 VOI 方法时,如果在研究的设计或分析阶段遗漏比较对象,可能会导致不正确的试验设计和/或治疗建议。总之,我们得出的结论是,忽略潜在的参照物而错误地指定健康经济模型会导致误导性的 VOI 结果,并可能浪费稀缺的研究资源。
Value of Information for Clinical Trial Design: The Importance of Considering All Relevant Comparators
Value of Information (VOI) analyses calculate the economic value that could be generated by obtaining further information to reduce uncertainty in a health economic decision model. VOI has been suggested as a tool for research prioritisation and trial design as it can highlight economically valuable avenues for future research. Recent methodological advances have made it increasingly feasible to use VOI in practice for research; however, there are critical differences between the VOI approach and the standard methods used to design research studies such as clinical trials. We aimed to highlight key differences between the research design approach based on VOI and standard clinical trial design methods, in particular the importance of considering the full decision context. We present two hypothetical examples to demonstrate that VOI methods are only accurate when (1) all feasible comparators are included in the decision model when designing research, and (2) all comparators are retained in the decision model once the data have been collected and a final treatment recommendation is made. Omitting comparators from either the design or analysis phase of research when using VOI methods can lead to incorrect trial designs and/or treatment recommendations. Overall, we conclude that incorrectly specifying the health economic model by ignoring potential comparators can lead to misleading VOI results and potentially waste scarce research resources.
期刊介绍:
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