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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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Evaluating Frameworks That Provide Value Measures for Health Care Interventions.

Jeanne S Mandelblatt¹, Scott D Ramsey², Tracy A Lieu³

¹Department of Oncology, Georgetown University Medical Center, Washington, DC, USA; Lombardi Comprehensive Cancer Center, Washington, DC, USA.

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research

|February 27, 2017

Summary

Evaluating health care value frameworks is crucial for informed decision-making. A new taxonomy helps assess these frameworks

Keywords:

cost-effectiveness multi-attribute decision analysis value frameworks

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Area of Science:

Health economics and outcomes research
Health services research
Medical decision making

Background:

Accelerated scientific discovery yields new health technologies with varied impacts on patients and populations.
Growing interest in health care value frameworks to assess benefits, toxicities, and costs.
Existing frameworks often focus on specific diseases or interventions.

Purpose of the Study:

To develop and apply an evaluation taxonomy for assessing the utility and potential biases of health care value frameworks.
To provide a structured approach for analyzing the components of value assessment tools.

Main Methods:

Created a seven-component evaluation taxonomy covering purpose, conceptual approach, inclusions/exclusions, data sources, cost impact, uncertainty, and conflicts of interest.
Applied the taxonomy to four representative value frameworks from professional organizations focusing on cancer, heart disease, and vaccine use.
Qualitative assessment of framework strengths and weaknesses based on the defined criteria.

Main Results:

Each evaluated value framework demonstrated both strengths and weaknesses when assessed using the proposed taxonomy.
The taxonomy provided a systematic method for identifying potential biases and limitations in value assessment.
Variations were observed in how frameworks defined purpose, incorporated patient preferences, and handled cost and uncertainty.

Conclusions:

The developed taxonomy offers a robust tool for critically appraising health care value frameworks.
Enhancements are needed to improve the utility and reduce potential biases in existing frameworks.
Recommendations are provided to strengthen value assessment for policy and clinical decision-making.