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Statistical Methods for Analyzing Epidemiological Data

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An R-Based Landscape Validation of a Competing Risk Model
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Published on: September 16, 2022

Development of a framework for cohort simulation in cost-effectiveness analyses using a multistep ordinary

Gerardus W J Frederix1, Johan G C van Hasselt1,2, Johan L Severens3

  • 1Department of Clinical Pharmacology & Experimental Therapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands (GWJF, JGCVH, JHMS)

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|March 22, 2013
PubMed
Summary

Using a modern ODE solver in cost-effectiveness analysis (CEA) reduces bias. This study implemented LSODA in R, showing single-step methods can underestimate outcomes like life-years gained in CEA.

Keywords:
Markov modelRcohort simulationcost-effectiveness analysistamoxifen

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Area of Science:

  • Health economics
  • Computational modeling

Background:

  • Cost-effectiveness analysis (CEA) often uses ordinary differential equations (ODEs) to model dynamic processes.
  • Commonly employed single-step ODE solvers may introduce bias due to incorrect step size selection.

Purpose of the Study:

  • Implement and demonstrate the LSODA ODE solver in R for CEA.
  • Quantify the bias introduced by single-step ODE solvers in CEA outcomes.

Main Methods:

  • A previously published CEA comparing breast cancer therapies was used as a case example.
  • Compared a single-step ODE solver with the multistep LSODA algorithm to assess bias.

Main Results:

  • Developed a computational framework using the LSODA ODE solver in R.
  • A single-step solver underestimated life-years gained by 5.6% and costs by 6.8% compared to LSODA.

Conclusions:

  • The LSODA framework is suitable for conducting CEAs.
  • Single-step ODE solvers can cause significant bias in CEA outcomes.
  • R enhances transparency and reproducibility in health economics research.