Results 31 to 45 of 131.
The prevention of Type 2 Diabetes is a major public health priority. We have developed a simulation model to evaluate and compare the cost-effectiveness of different diabetes prevention interventions. This discussion paper presents a series of detailed methods used to build and run the model, including model assumptions, model validation and parameter values and distributions used in the model.
P Breeze, C Thomas, H Squires, A Brennan, C Greaves, P Diggle, E Brunner, A Tabak, L Preston, J Chilcott
Diary survey data is used to describe individuals’ drinking occasions and estimate alcohol-attributable fractions for road traffic and non-road traffic accidents. Statistical methods and numerical integration are used to combine the evidence on the risk of injury when intoxicated with the diary data. Overall, an estimated 27% of road traffic accident and 23% of non-road traffic accident injuries in Britain are attributable to alcohol. Our findings indicate that the burden of injuries from road traffic accident in England has been previously overestimated.
D Hill-McManus, C Angus, Y Meng, J Holmes, A Brennan, P S Meier
Assessing methods for dealing with treatment crossover in clinical trials: A follow-up simulation study
In this paper we assess statistical approaches for adjusting survival estimates in the presence of treatment switching in order to determine which methods are most appropriate in a new range of realistic scenarios. This builds upon previous research and allows us to extend previous guidance on how to address the treatment switching problem
NR Latimer, KR Abrams, PC Lambert, MJ Crowther, JP Morden
Are we over-estimating the value of further research? A review of methods used to estimate uptake in population expected value of information analyses
With this paper, we would like to spark a discussion around uptake adjustments in population expected value of information (PEVI) analyses and directions for further research needed in this area. We conducted a review of PEVI analyses using the NHS Economic Evaluation Database (EED) to investigate how population estimates for the PEVI were obtained. Most studies had based their population estimate on incidence and prevalence, disregarding technology uptake as a factor in the number of patients that will actually benefit from further research. We argue that this may result in over-estimating the PEVI in technologies where full implementation is not achieved.
S Grimm, S Dixon, S W Stevens
The impact of amblyopia treatment upon a child's health-related quality of life is a relatively under researched area. The Child Amblyopia Treatment Questionnaire (CAT-QoL) was developed to assess the impact of treatment from the child's perspective. This paper evaluates the psychometric properties of the CAT-QoL measure, reporting on it's reliability and validity in a patient sample.
The impact of amblyopia treatment upon a child's health-related quality of life is a relatively under researched area. The Child Amblyopia Treatment Questionnaire (CAT-QoL) was developed to assess the impact of treatment from the child's perspective. This paper reports upon the refinement of the draft measure using Rasch analysis techniques.
Monica Hernandez-Alava, Christopher James Sampson, Allan Wailoo
Estimation of own and cross price elasticities of alcohol demand in the UK – a pseudo-panel approach
Estimation of own and cross price elasticities of alcohol demand in the UK – a pseudo-panel approach using the Living Costing and Food Survey 2001 to 2009
Y. Meng, A. Brennan, R. Purshouse, D. Hill-McManus, C. Angus, J. Holmes, P.S. Meier
Price elasticities describe how demand for a good responds to changes in the price of that good. Estimating price elasticities for alcohol is challenging due to limitations in the available data on prices and spending. This paper presents new own-price and cross-price elasticities for alcohol estimated using a novel method for analysing repeated cross-sectional spending diaries known as the pseudo-panel approach. Results suggest beer and cider sold in the off-trade (e.g. shops) are the products which see the biggest reductions in demand following a price increase while spirits and alcopops sold in the on-trade (e.g. pubs and restaurants) see the smallest reductions in demand."
Modelling the potential cost-effectiveness of a targeted follow-up intervention to improve glycaemic
Modelling the potential cost-effectiveness of a targeted follow-up intervention to improve glycaemic response following structured training in flexible intensive insulin therapy
J Kruger, A Brennan, P Thokala, H Basarir, D Cooke, M Clark, R Bond, S R Heller
This study estimates the cost-effectiveness of a hypothetical follow-up intervention targeted at people with type 1 diabetes who have undertaken structured training in flexible intensive insulin therapy. Behavioural data were incorporated into the Sheffield Type 1 Diabetes Policy Model to estimate the lifetime costs and quality-adjusted life years of a follow-up intervention targeted at people not predicted to achieve glycaemic targets compared with no structured follow-up. The results suggest such a follow-up intervention could be considered cost-effective if adequate glycaemic improvement could be realised, and further research into the design and development of a follow-up intervention is indicated.
The "gender system" that assigns the breadwinner role to fathers and the caring roles to mothers may contribute to the gender gap in longevity. This study examines the statistical association between the division of parental roles and subsequent mortality of a population of all Swedish men and women who had their first child together in 1988/89 (over 100 thousand couples).
Anna Mansdotter , Aki Tsuchiya, Mona Backhans, Johan Hallqvist, Michael Lundberg, Andreas Lundin, Lars Lindholm
Health economic models are developed as part of the health technology assessment process in order to determine whether health interventions represent good value for money. The information needs for the model require the use of other types of information beyond clinical effectiveness evidence in order to populate the model parameters. We conducted a series of focus groups with UK HTA experts to explore some of the issues associated with identifying and reviewing this evidence.
Key issues raised by the focus group respondents included the need for effective communication and teamwork throughout the model development process, the importance of using clinical experts as well as the need for transparent reporting of methods and decisions.
M Essat, P Tappenden, E Kaltenthaler S Paisley
Binary choice methods for the valuation of health states have increased in popularity in recent years.
In this paper we use CAPI methods to assess the validity and acceptability of binary choice versions
of TTO, LT-TTO and DCETTO.
B Mulhern, A Tsuhiya, N Devlin, K Buckingham, D Rowen, J Brazier
Adjusting survival time estimates to account for treatment switching in randomised controlled trials
Adjusting survival time estimates to account for treatment switching in randomised controlled trials – a simulation study.
Treatment switching commonly occurs in clinical trials of novel interventions, particularly in the advanced or metastatic cancer setting, which causes important problems for health technology assessment. It is unclear which methods to adjust for switching are most appropriate in realistic scenarios.
We aimed to assess statistical approaches for adjusting survival estimates in the presence of treatment switching in order to determine which methods are most appropriate in a range of realistic scenarios. We conducted a simulation study to assess the bias, mean squared error and coverage associated with alternative switching adjustment methods across a wide range of realistic scenarios.
We found that randomisation-based methods (such as the Rank Preservinig Structural Failure Time Model) can accurately adjust for treatment switching when the treatment effect received by patients that switch is the same as that received by patients randomised to the experimental group.
When this is not the case observational-based methods (such as Inverse Probability of Censoring Weights (IPCW)) or simple two-stage methods should be considered, although the IPCW is prone to substantial bias when the proportion of patients that switch is greater than approximately 90%. Simple methods such as censoring or excluding patients that switch should not be used.
N Latimer, R Akehurst, A Wailoo
The Sheffield Type 1 Diabetes Policy Model is a patient-level simulation model of type 1 diabetes and its associated complications, which was developed as part of the National Institute for Health Research Dose Adjustment for Normal Eating (DAFNE) research programme.The aim of this paper is to describe the conceptual modelling, model implementation, and model validation phases of the Sheffield Type 1 Diabetes Model development process. The model is highly flexible and has broad potential application to evaluate DAFNE, other diabetes structured education programmes, and other interventions for type 1 diabetes.
P Thokala, J Kruger, A Brennan, H Basarir, A Duenas, A Pandor, M Gillett, J Elliot, S Heller
Using preference based measures in mental health conditions: The psychometric validity of the EQ-5D and SF-6D. The generic preference based measures EQ-5D and SF-6D are widely used in the economic evaluation of interventions and treatments across. In this paper we assess the psychometric performance of the measures across a range of mental health conditions using existing datasets.
B Mulhern, C Mukuria, M Barkham, M Knapp, S Byford, D Soeteman, J Brazier