MDM Policy and Practice最新文献

{"title":"Reflecting on the Universal Meaning of Numbers in Health and Risk Communication.","authors":"Marilyn M Schapira","doi":"10.1177/23814683251314519","DOIUrl":"10.1177/23814683251314519","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683251314519"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Difference Tasks Are Affected by Probability Format, Part 2: A Making Numbers Meaningful Systematic Review.","authors":"Natalie C Benda, Brian J Zikmund-Fisher, Mohit M Sharma, Stephen B Johnson, Michelle Demetres, Diana Delgado, Jessica S Ancker","doi":"10.1177/23814683241310242","DOIUrl":"https://doi.org/10.1177/23814683241310242","url":null,"abstract":"<p><p><b>Background.</b> To evaluate the effect of data presentation format on communication of health probabilities, the Making Numbers Meaningful team undertook a systematic review. <b>Purpose.</b> This article presents evidence about difference tasks, in which a reader examines information to evaluate differences between probabilities, such as the effect of a therapy on the chance of recurrence. This article covers the effect of format on 5 outcomes: 1) perceptions of or feelings about effectiveness, 2) behavioral intentions or behaviors, 3) trust, 4) preference for the format, and 5) discrimination. <b>Data Sources.</b> MEDLINE, Embase, CINAHL, the Cochrane Library, PsycINFO, ERIC, ACM Digital Library; hand search. <b>Finding Selection.</b> Experimental/quasi-experimental studies comparing 2 or more formats for presenting quantitative health information. This article covers 205 findings from 101 unique studies reported in 84 articles. <b>Data Extraction.</b> Dual extraction of information on stimulus, task, and perceptual, affective, cognitive, and behavioral outcomes. <b>Data Synthesis.</b> Evidence is moderate to strong that behavioral intention is affected more by relative differences than absolute ones, by numerator-only graphics than part-to-whole graphics, by messages with anecdotes than without, and by information about what others chose. Evidence is strong that perceived and felt effectiveness is affected more by relative differences than by absolute ones and more by numerator-only graphics rather than part-to-whole graphics. For graphic preferences, bar charts were preferred to icon arrays and graphics with data labels to graphics without. Other comparisons had weak or insufficient evidence. <b>Limitations.</b> The detailed approach to evidence syntheses provides narrowly targeted evidence rather than broad statements. <b>Conclusions.</b> Moderate to strong evidence can be derived on effects of probability difference format on behavioral intention, perceived or felt effectiveness, and preference for format.</p><p><strong>Highlights: </strong>Communicating relative risk differences as opposed to absolute risk differences, using numerator-only instead of part-to-whole graphics, and including anecdotes or information about others' decisions will all increase intentions to engage in a behavior.Relative risks (rather than absolute risk differences) and numerator-only graphics (rather than part-to-whole) will also increase felt and perceived effectiveness.To illustrate probability differences, people tend to prefer bar charts over icon arrays and graphics with labels over those without.All findings regarding the impact of different presentation formats for probability differences on trust produced insufficient evidence.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241310242"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Peer Review Process for the Making Numbers Meaningful Article Collection and Thanks to Collection Editor Marilyn Schapira.","authors":"Lauren E Cipriano","doi":"10.1177/23814683251314513","DOIUrl":"https://doi.org/10.1177/23814683251314513","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683251314513"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritizing Patients from the Most Deprived Areas on Elective Waiting Lists in the NHS in England: Estimating the Health and Health Inequality Impact.","authors":"Naomi Kate Gibbs, Susan Griffin, Nils Gutacker, Adrián Villaseñor, Simon Walker","doi":"10.1177/23814683241310146","DOIUrl":"10.1177/23814683241310146","url":null,"abstract":"<p><p><b>Introduction.</b> Reducing hospital waiting lists for elective procedures is a policy concern in the National Health Service (NHS) in England. Following growth in waiting lists after COVID-19, the NHS published an elective recovery plan that includes an aim to prioritize patients from deprived areas. We use a previously developed model to estimate the health and health inequality impact under hypothetical targeted versus universal policies to reduce waiting time. <b>Methods.</b> We use a Markov model to estimate the health impact of waiting, by index of multiple deprivation quintile group, for 8 elective procedures. We estimate patients' remaining quality-adjusted life-years (QALYs) with baseline waiting times and under 2 hypothetical policy scenarios: 1) a universal policy in which all patients receive an equal reduction in wait and 2) a targeted policy in which patients living in the most deprived quintile are prioritized. We estimate individual and population level health under each of the 2 policies and compare it with baseline. We also estimate how health inequality changes from baseline using the slope index of inequality, reflecting the difference in health between the least and most deprived quintile based on QALYs. <b>Results.</b> A universal reduction in waiting time is estimated to improve overall population health but increase health inequality. A targeted reduction would achieve nearly the same overall health gain and would also increase population-level health inequalities but to a lesser extent than the universal policy would. <b>Discussion.</b> If the NHS is successful in prioritizing patients on waiting lists from the most deprived areas, this may result in smaller increases in health inequalities while maintaining a similar level of overall health gain compared with a universal policy.</p><p><strong>Highlights: </strong>The NHS elective recovery plans include prioritizing patients who live in the most deprived areas of England.Evaluating a hypothetical targeted wait time reduction policy against a universal wait time reduction policy suggests almost the same level of population health gain could be achieved while lessening the negative impact on health inequality.Expected outcomes of government health policies should be quantified to explore the impact on both health maximization and health inequality minimization, as both represent legitimate policy concerns.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241310146"},"PeriodicalIF":1.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Concordant and Shared Lung Cancer Screening Decision Making with Decisional Conflict: A Multi-Institution Cross-Sectional Analysis.","authors":"Donald R Sullivan, Sara E Golden, Liana Schweiger, Anne C Melzer, Santanu Datta, James M Davis, Renda Soylemez Wiener, Christopher G Slatore","doi":"10.1177/23814683241309945","DOIUrl":"10.1177/23814683241309945","url":null,"abstract":"<p><p><b>Introduction.</b> Many organizations recommend structured communication processes, including formal shared decision making (SDM), for patients undergoing lung cancer screening (LCS) using low-dose computed tomography (LDCT). We sought to understand if concordant and shared LCS decision making was associated with decisional conflict. <b>Methods.</b> In this prospective, observational study, we enrolled patients from 3 medical centers (2 Veterans Health Administration, 1 academic facility) after a decision-making interaction about undergoing LCS but before receiving the LDCT. We included patients who indicated they accepted or declined to undergo the LDCT. We evaluated preferred and actual decision-making roles and used multivariable linear and logistic regression models to measure the association of concordant (congruence between actual and preferred roles) and shared LCS decision making with decisional conflict to report adjusted odds ratios (AOR). <b>Results.</b> Of the 409 participants with nonmissing information, 83% reported LCS decision-making role concordance. In addition, 223 (58%) reported an indeterminate level and 56 (14%) reported decisional conflict. LCS decision-making role concordance was not associated with decisional conflict (AOR = 0.86, 95% confidence interval [CI]: 0.38-1.94, <i>P</i> = 0.71) compared with role discordance. Participant-reported actual LCS SDM role was not associated with decisional conflict (AOR = 0.99, 95% CI: 0.51-1.93, <i>P</i> = 0.98) compared with patient- or provider-controlled roles. <b>Conclusions.</b> LCS decisional conflict was uncommon, although many patients reported an indeterminate level of decisional conflict. Neither concordant nor shared LCS decision-making role was associated with decisional conflict. Clinicians may be unable to decrease LCS decisional conflict using efforts to enhance decision-making interactions.</p><p><strong>Highlights: </strong>We evaluated patients' preferred and actual decision-making role and decisional conflict following a decision-making interaction about lung cancer screening (LCS).Concordant decision-making preference was not associated with decisional conflict.Actual decision-making role was also not associated with decisional conflict.Efforts to enhance decision-making interactions may not decrease LCS decisional conflict.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241309945"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of Diminishing Lifespan Marginal Utility for Valuing Equity in Cost-Effectiveness Analysis.","authors":"R Scott Braithwaite","doi":"10.1177/23814683241305106","DOIUrl":"10.1177/23814683241305106","url":null,"abstract":"<p><p><b>Introduction.</b> Diminishing marginal lifespan utility (DMLU) implies that a particular lifespan increment (e.g., 1 life-year) confers lesser marginal utility if added to longer lifespans (e.g., 90 y to 91 y) than to shorter lifespans (e.g., 60 y to 61 y) if quality of life is unchanged. Because DMLU is difficult to disambiguate from discounting, risk attitude, and other elements of utility \"curvature,\" it is poorly characterized. However, the imperative to consider equity in cost-effectiveness analysis (CEA) renders its characterization more important. <b>Methods.</b> I add certainty to the characterization of DMLU through literature review and illustrative example. The literature review synthesizes stated preference studies of utility curvature that exclude risk or probability. The example compares alternative valuations of approaches to reduce inequality in cystic fibrosis outcomes between US centers serving mostly White patients and centers serving mostly non-Black Hispanic patients, with versus without DMLU. <b>Results.</b> The existence of DMLU is likely, and empirical data support its relevance over typical CEA time horizons. The imperative to consider equity in CEA magnifies the importance of DMLU for several reasons. First, intergenerational CEAs require lower discount rates that are less likely to incidentally absorb DMLU. Second, DMLU is incompatible with the use of absolute measures of inequality aversion. Third, DMLU may bias the interpretation of relative measures of inequality aversion toward prioritarianism. Finally, not considering DMLU implicitly biases life-year-based metrics against equity. <b>Conclusion.</b> DMLU is likely to exist, can benefit from additional characterization, and may merit inclusion in CEA alongside discounting. Omitting consideration of DMLU will sometimes confer an antiequity bias and may affect the interpretation of CEAs incorporating inequality aversion.</p><p><strong>Highlights: </strong>Diminishing marginal lifespan utility (DMLU) means that the value of extending lifespan may differ based on the duration of life already lived.DMLU is not typically considered in cost-effectiveness analyses.Not considering DMLU may bias cost-effectiveness analyses against equity.Not considering DMLU may reduce the accuracy of distributive cost-effectiveness analyses and other approaches to consider equity along with efficiency.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241305106"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Masks and Random Screening Test Usage within K-12 Schools.","authors":"Yiwei Zhang, Maria E Mayorga, Julie S Ivy, Julie L Swann","doi":"10.1177/23814683241312225","DOIUrl":"10.1177/23814683241312225","url":null,"abstract":"<p><p><b>Background.</b> COVID-19 tremendously disrupted the global health system. People of all ages were at risk of becoming infected. Frequent school closures raised concerns about both the physical and mental health of school-age children. Many studies discussed the effectiveness of various interventions, while few focused on optimizing such interventions. <b>Methods.</b> This study aimed to optimize the usage of random screening tests and masking requirements within K-12 schools. We simulated the disease transmission within a school setting and sought to find the most efficient schedules for schools to arrange their weekly screening tests and mask mandates. The goal was to minimize the number of the end-of-semester infections as well as to use the minimum number of resources. We applied the nondominated sorting genetic algorithm, NSGA-II, to solve this multiobjective optimization problem. We also compared results when polymerase chain reaction (PCR) versus rapid antigen tests were used. <b>Results.</b> The NSGA successfully found Pareto solutions when optimizing the end-of-semester infections, the total number of tests, and the total number of weeks masking. The screening tests and masks can serve as alternatives to one another when prioritizing minimizing the number of infections. In addition, due to the faster return of testing results and lower accuracy, the rapid antigen tests had a similar effect as PCR tests. <b>Conclusion.</b> Our study provides policy makers in K-12 schools with valuable insights. The conclusions derived from this research can serve as a solid foundation for making informative decisions regarding random screening tests and universal masking policies.</p><p><strong>Highlights: </strong>Our simulation optimization framework was used to design weekly schedules for random screening tests and masking within K-12 schools to mitigate COVID-19 infections.We considered multiple objectives and applied the NSGA-II algorithm to find a Pareto solution set.Based on local context and preferences, decision makers can trade off testing and masking to achieve a similar number of end-of-semester infections.When a few weeks of masks are mandated, it is best to use them at the beginning of a semester.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241312225"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Working toward Personalized Intervention Advice: A Survey Study on Preference Heterogeneity in Patients with Breast Cancer-Related Fatigue.","authors":"Lian Beenhakker, Kim A E Wijlens, Christina Bode, Miriam M R Vollenbroek-Hutten, Sabine Siesling, Janine A van Til, Annemieke Witteveen","doi":"10.1177/23814683241309676","DOIUrl":"10.1177/23814683241309676","url":null,"abstract":"<p><p><b>Introduction.</b> Many breast cancer survivors experience cancer-related fatigue (CRF), and several interventions to treat CRF are available. One way to tailor intervention advice is based on patient preferences. In this study, we explore preference heterogeneity regarding between-attribute and within-attribute preferences. In addition, we propose simple decision rules to match preferences to interventions. <b>Methods.</b> Nine attributes were included with dichotomized levels. Participants selected their preferred level per attribute and ranked the attributes using best-worst scaling. Between-attribute and within-attribute preferences were determined, together with their heterogeneity. Using decision rules, matching scores were calculated for a hypothetical intervention. <b>Results.</b> Sixty-seven breast cancer survivors completed the survey. They were on average 52 y old, 4.5 y after diagnosis, experienced CRF (6.5-7.2/10) on 3 dimensions (physical, mental, and emotional), and 43% already followed an intervention for CRF. Overall, participants ranked <i>costs</i> highest. Next to <i>costs</i>, <i>proven</i> <i>effectiveness</i> and <i>type of intervention</i> were also frequently ranked first. Only 13 participants (19%) shared the most common preference pattern of shorter interventions, daily sessions, shorter session time, a psychosocial intervention, no anonymity, and contact with a therapist and peers. Matching scores for a hypothetical intervention with attributes corresponding with the overall within-attribute preferences varied from 44% to 100%. <b>Conclusion.</b> A large heterogeneity in preferences of breast cancer survivors for CRF intervention attributes was demonstrated. Using simple decision rules, the effect of this heterogeneity on linking preferences to interventions with matching scores was demonstrated. <b>Implications.</b> Personalization of intervention advice is necessary due to preference heterogeneity. Tailored advice can result in higher involvement of patients in decision making, intervention adherence and satisfaction, and subsequently a potential higher quality of life after breast cancer.</p><p><strong>Highlights: </strong>Many breast cancer survivors experience cancer-related fatigue for which many interventions exist.Our results show large preference heterogeneity in breast cancer patients' preferences for attributes of eHealth interventions.Based on this preference heterogeneity, intervention advice for cancer-related fatigue after breast cancer can be personalized, ultimately improving quality of life after breast cancer.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241309676"},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Soda Tax on Obesity and Diabetes in California: A Cost-Effectiveness Analysis.","authors":"Fan Zhao, Risha Gidwani, May C Wang, Liwei Chen, Roch A Nianogo","doi":"10.1177/23814683241309669","DOIUrl":"10.1177/23814683241309669","url":null,"abstract":"<p><p><b>Introduction.</b> Consumption of sugar-sweetened beverages (SSBs) contributes to weight gain, obesity, and diabetes. Soda tax has been proposed to reduce consumption of SSBs. What remains unclear is whether the soda tax has an effect on health and health care costs. We evaluated the cost-effectiveness of a 1-cent-per-ounce soda tax on obesity and diabetes in California. <b>Methods.</b> A microsimulation state-transition model was used to evaluate the cost-effectiveness of the soda tax. Health outcomes were measured in quality-adjusted life-years (QALYs). Health care costs were projected from 2015 to 2035. <b>Results.</b> In a simulated cohort of Californian adults, the soda tax policy prevented 2.28 million cases of overweight (95% confidence interval [CI] -0.06 to 6.63) and 0.49 million cases of obesity (95% CI -0.19 to 1.18). From the health care perspective, the incremental cost-effectiveness ratio of the soda tax was $124,839 dollars per QALY (95% CI -1,151,983 to 557,660). From the health care perspective, the soda tax policy was cost-effective 80% of the time in the probabilistic sensitivity analysis using a willingness-to-pay threshold of $100,000 per QALY. <b>Conclusions.</b> The 1-cent-per-ounce soda tax reduced the number of obesity cases, diabetes cases, and related complications. In addition, the soda tax policy implemented in California was cost-effective most of the time.</p><p><strong>Highlights: </strong>Question: What remains unclear is whether the soda tax has an effect on health and health care costs.Findings: The 1-cent-per-ounce soda tax reduced the number of obesity cases, diabetes, and related complications. In addition, the soda tax policy brought large amounts of revenue.Meaning: This study provides additional evidence regarding the health care costs and cost-effectiveness related to the implementation of a soda tax.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241309669"},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Economic Modeling to Inform a Target Product Profile: A Case Study of a Novel Rapid Test for <i>Clostridioides difficile</i> Infection.","authors":"Paola Cocco, Alison Florence Smith, Kerrie Ann Davies, Christopher Michael Rooney, Robert Michael West, Bethany Shinkins","doi":"10.1177/23814683241293739","DOIUrl":"10.1177/23814683241293739","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background.&lt;/b&gt; Target product profiles (TPPs) specify the essential properties tests must have to be able to address an unmet clinical need. &lt;b&gt;Aim.&lt;/b&gt; To explore how early economic modeling can help to define TPP specifications based on cost-effectiveness considerations using the example of a new rapid diagnostic for &lt;i&gt;Clostridioides difficile&lt;/i&gt; infection (CDI), a contagious health care-associated infection causing potentially fatal diarrhea. &lt;b&gt;Methods.&lt;/b&gt; A resource-constrained simulation model was developed to compare a hypothetical test for CDI with current practice (i.e., test with glutamate dehydrogenase enzyme immunoassay first; if positive, test with polymerase chain reaction and cytotoxicity assay) for adult individuals with suspected CDI at the Leeds Teaching Hospital National Health System (NHS) Trust in the United Kingdom. Parameters are taken from UK-based observational data collected between 2018 and 2021, published literature, and expert opinion. A methodological framework was developed 1) to derive minimum diagnostic sensitivity and specificity and maximum price for different test turnaround-time values based on cost-effectiveness considerations from the health care perspective using the National Institute of Health Care Excellence willingness-to-pay threshold of £20,000 per quality-adjusted life-years and 2) to test their robustness using a series of sensitivity analyses. &lt;b&gt;Results.&lt;/b&gt; A new rapid test for CDI with a 15-min turnaround time would require a minimum diagnostic sensitivity and specificity both equal to 96% and a maximum price of £44 to maintain cost-effectiveness compared with standard of care. &lt;b&gt;Conclusions.&lt;/b&gt; This study provides a framework to inform the essential test properties based on cost-effectiveness considerations and to isolate the most influential model parameters and scenarios via a series of sensitivity analyses. These specifications, in turn, could be used to inform future TPPs for tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Highlights: &lt;/strong&gt;Target product profiles (TPPs) for new medical tests provide test developers with performance benchmarks and technical requirements for new tests. Early economic evaluation has already been used to identify acceptable ranges for certain performance requirements for new tests. Currently, however, early economic evaluation methods are yet to be used in the context of TPP development, and there is no guidance as to how this could and should be done.A de novo approach was developed to identify the minimum performance requirements and maximum costs for new tests, based on cost-effectiveness considerations, while also isolating most influential parameters. The added value of this framework lies in structuring early economic evaluation methods as a means of informing transparent, evidence-based minimum TPP performance specifications while also accounting as much as possible for the (inevitable) uncertainty surrounding the minimum performance requirements.This study repr","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"9 2","pages":"23814683241293739"},"PeriodicalIF":1.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}