A structured process for the validation of a decision-analytic model: application to a cost-effectiveness model for risk-stratified national breast screening

IF 3.1 4区医学 Q1 ECONOMICS

Applied Health Economics and Health Policy Pub Date : 2024-05-16 DOI:10.1007/s40258-024-00887-z

Stuart J. Wright, Ewan Gray, Gabriel Rogers, Anna Donten, Katherine Payne

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引用次数: 0

Abstract

Background

Decision-makers require knowledge of the strengths and weaknesses of decision-analytic models used to evaluate healthcare interventions to be able to confidently use the results of such models to inform policy. A number of aspects of model validity have previously been described, but no systematic approach to assessing the validity of a model has been proposed. This study aimed to consolidate the different aspects of model validity into a step-by-step approach to assessing the strengths and weaknesses of a decision-analytic model.

Methods

A pre-defined set of steps were used to conduct the validation process of an exemplar early decision-analytic-model-based cost-effectiveness analysis of a risk-stratified national breast cancer screening programme [UK healthcare perspective; lifetime horizon; costs (£; 2021)]. Internal validation was assessed in terms of descriptive validity, technical validity and face validity. External validation was assessed in terms of operational validation, convergent validity (or corroboration) and predictive validity.

Results

The results outline the findings of each step of internal and external validation of the early decision-analytic-model and present the validated model (called ‘MANC-RISK-SCREEN’). The positive aspects in terms of meeting internal validation requirements are shown together with the remaining limitations of MANC-RISK-SCREEN.

Conclusion

Following a transparent and structured validation process, MANC-RISK-SCREEN has been shown to have satisfactory internal and external validity for use in informing resource allocation decision-making. We suggest that MANC-RISK-SCREEN can be used to assess the cost-effectiveness of exemplars of risk-stratified national breast cancer screening programmes (NBSP) from the UK perspective.

Implications

A step-by-step process for conducting the validation of a decision-analytic model was developed for future use by health economists. Using this approach may help researchers to fully demonstrate the strengths and limitations of their model to decision-makers.

Abstract Image

查看原文本刊更多论文

验证决策分析模型的结构化流程：应用于风险分层国家乳腺筛查的成本效益模型。

背景：决策者需要了解用于评估医疗保健干预措施的决策分析模型的优缺点，以便能够自信地使用这些模型的结果为政策提供依据。以前曾对模型有效性的多个方面进行过描述，但尚未提出评估模型有效性的系统方法。本研究旨在将模型有效性的不同方面整合为一个逐步评估决策分析模型优缺点的方法：方法：采用一套预先确定的步骤，对基于早期决策分析模型的全国乳腺癌筛查项目风险分级成本效益分析范例进行验证[英国医疗保健视角；终生范围；成本（英镑；2021 年）]。内部验证从描述有效性、技术有效性和表面有效性三个方面进行评估。外部验证从操作验证、聚合验证（或确证）和预测验证方面进行评估：结果：结果概述了早期决策分析模型内部和外部验证每个步骤的结果，并介绍了经过验证的模型（称为 "MANC-RISK-SCREEN"）。结论：经过透明、有序的验证过程，MANC-RISK-SCREEN 在为资源分配决策提供信息方面具有令人满意的内部和外部有效性。我们建议，MANC-RISK-SCREEN 可用于从英国的角度评估风险分层国家乳腺癌筛查计划（NBSP）范例的成本效益：我们开发了一个逐步验证决策分析模型的流程，供卫生经济学家今后使用。使用这种方法可以帮助研究人员向决策者充分展示其模型的优势和局限性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Applied Health Economics and Health Policy Economics, Econometrics and Finance-Economics and Econometrics

CiteScore

6.10

自引率

2.80%

发文量

期刊介绍： Applied Health Economics and Health Policy provides timely publication of cutting-edge research and expert opinion from this increasingly important field, making it a vital resource for payers, providers and researchers alike. The journal includes high quality economic research and reviews of all aspects of healthcare from various perspectives and countries, designed to communicate the latest applied information in health economics and health policy. While emphasis is placed on information with practical applications, a strong basis of underlying scientific rigor is maintained.