Discussion Papers

Results 16 to 30 of 127.

  • Monica Hernandez Small

    Copula-based modelling of self-reported health states

    Copula-based modelling of self-reported health states An application to the use of EQ-5D-3L and EQ-5D-5L in evaluating drug therapies for rheumatic disease

    EQ-5D is used in cost-effectiveness studies underlying many important health policy decisions. The original 3-level version of EQ-5D is being replaced with a more sensitive 5-level version but there little is known about the consequences of this change. In this paper, we develop new statistical methods to investigate how well the old and new versions of EQ-5D work, and we find systematic differences in the way they measure mobility problems and pain. We use the findings to re-examine a cost-effectiveness evaluation of alternative drug therapies for rheumatoid arthritis.

    M Hernandez-Alava, S Pudney

  • Rosie

    Understanding the experience and impact of living with a vascular condition

    This paper presents a protocol to summarise the process used to conduct a qualitative evidence synthesis of patient experiences for five key vascular conditions; peripheral arterial disease, carotid artery disease, abdominal aortic aneurysm, varicose veins and venous leg ulcers. The synthesis will form part of a wider project identifying patient outcomes for the included vascular conditions.

    R Duncan, A Booth, H B Woods, M Essat, P Phillips, E Poku, E Kaltenthaler, G Jones, J Michaels

  • Essat1

    Patient reported outcome measures in patients with abdominal aortic aneurysms

    Patient reported outcome measures (PROMs) are increasing being used in clinical practice to assess the quality of life of patients. However, PROMs used to assess quality of life of patients with abdominal aortic aneurysm (AAA) in clinical setting are equivocal in terms of their reliability, validity and suitability. The aim of this protocol is to outline the systematic process we intend to use to identify, summarise and assess PROMs that have been administered in patients with AAA.

    M Essat, E Poku, R Duncan, P Phillips, H Woods, S Palfreyman, G Jones, E Kaltenthaler and J Michaels

  • vanhout2

    New methods for modelling EQ-5D-5L value sets: an application to English data

    This paper provides details of how the EQ-5D-5L value set was derived, focusing on the methods used to model the stated preference data. Results for different model specifications, and taking different interpretations of the data, are presented and discussed. This paper is intended to accompany HEDS Discussion Paper ‘Valuing health-related quality of life: an EQ-5D-5L value set for England’.

    Y Feng, N Devlin, K Shah, B Mulhern, B van Hout

  • ndevlin

    Valuing Health-Related Quality of Life: An EQ-5D-5L Value Set for England

    This paper reports the methods and findings from the EQ-5D-5L value set for England study. The value set is derived from the stated preference data of 996 members of the English general public. The study design followed the EuroQol Group’s international protocol for valuing EQ-5D-5L health states. A single value set is reported, and implications for public decisions made using EQ-5D-5L data are discussed. This paper is intended to accompany HEDS Discussion Paper ‘New methods for modelling EQ-5D-5L value sets: an application to English data’.

    N Devlin, K Shah, Y Feng, B Mulhern, B van Hout

  • poku2

    Patient-reported outcome measures in patients with peripheral artery disease:

    Peripheral arterial disease (PAD) of the lower limbs is associated with substantial morbidity and functional limitation. In recent times, policy-makers, clinicians and researchers have demonstrated an increased interest in patient-reported outcome measures (PROMs) as relevant clinical indicators of health status and health-related quality of life. To demonstrate the real benefits and risks of treatments, instruments used in clinical settings must provide reliable and valid outcome measures. A clear understanding of the measurement properties of available PROMs in patients with PAD is needed. This is a protocol of a systematic review of PROMs validated in patients with PAD.

    E Poku, M Essat, R Duncan, P Phillips, H Woods, S Palfreyman, G Jones, E Kaltenthaler, J Michaels

  • Latimer2

    The Challenge of Early Crossover in Oncology Trials

    This paper was provided as preparatory reading to attendees of the meeting on “The Challenge of Early Crossover in Oncology Trials” held in Adelaide, Australia, in October 2014. The paper introduces the concept of treatment switching in randomised controlled trials of oncology treatments, the problems it causes for estimating the treatment effect associated with the new treatment, and the methods available for adjusting for treatment switching. The paper is not exhaustive, and does not cover every issue associated with treatment switching in detail. However it aims to provide an overview of the key issues associated with treatment switching in the context of oncology trials.

    N Latimer

  • Katherine Stevens Small

    A pilot study to test the feasibility and reliability of health state valuation with children

    This study sought to test whether it is feasible and reliable to obtain children's preferences for paediatric health states from the Child Health Utility 9D (CHU9D) using pair wise discrete choice experiment and best worst scaling techniques.

    Interviews with children were carried out and cognitive debriefing techniques were used to determine whether children could understand and respond to the tasks.

    This research demonstrated that it is feasible and reliable to obtain children's preferences and there is potential for future valuation studies of child utility measures to obtain child preference weights using these methods.

    K Stevens

  • Laura Gibson Small

    The Effects of Breastfeeding on Childhood BMI: A Propensity Score Matching Approach

    "This paper investigates the effect of breastfeeding on childhood body mass index (BMI). We use data from the Millennium Cohort Study (MCS), a nationally representative UK cohort survey, containing detailed infant feeding information, which allow us to explore the effects of a range of breastfeeding variables on the mean BMI of children breastfed for different durations and for exclusive and partial breastfeeding."

    L Gibson, M Hernandez Alava, M P Kelly, M J Campbell

  • Sabine Grimm Small

    Assessing the expected value of research resolving uncertainty and improving implementation

    With low implementation of cost-effective health technologies being a problem, it may be worth considering the potential effect of research on implementation at the time of technology appraisal. We extend an existing framework to assess the values of information and implementation to account for the relationship between information and implementation and to reflect implementation dynamics. We demonstrate in a genuine case study that incorporating implementation dynamics significantly affect the expected value of research. This framework has the potential to complement currently used analyses in health technology appraisals.

    S Grimm, S Dixon, J W Stevens

  • Milad Karimi Small

    The Capability Approach: A critical review of its application in health economics

    This paper discusses the application of the capability approach in health economics. In particular it critically reviews several attempts to develop questionnaires to measure and value capability at an individual level in health economics. We raise some concerns about existing methods used to measure and value capability.

    M Karimi, J E Brazier, H Basarir

  • C Thomas Discussion Paper Image

    SPHR Diabetes Prevention Model: Detailed Description of Model

    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

  • Angus2

    Injury Alcohol-Attributable Fractions: Methodological Issues and Developments

    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

  • Latimer2

    Assessing methods for dealing with treatment crossover in clinical trials:

    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

  • Sabine Grimm Small

    Are we over-estimating the value of further research?

    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