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Developing a reference protocol for structured expert elicitation in health-care decision-making: a mixed-methods

Laura Bojke1, Marta Soares1, Karl Claxton1

  • 1Centre for Health Economics, University of York, York, UK.

Health Technology Assessment (Winchester, England)
|June 9, 2021
PubMed
Summary
This summary is machine-generated.

This study developed a flexible protocol for structured expert elicitation to improve health-care decision-making under uncertainty. The protocol offers guidance on collecting and using expert judgments for cost-effectiveness analysis.

Keywords:
DECISION-MAKINGEXPERT ELICITATIONHEALTHTRANSPARENCYUNCERTAINTY

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Area of Science:

  • Health Economics
  • Decision Science
  • Evidence Synthesis

Background:

  • Health-care decisions often maximize health outcomes within cost-effectiveness frameworks, requiring expert judgment when evidence is uncertain.
  • Structured expert elicitation (SEE) is a formal method for quantifying expert beliefs, but existing methodologies lack consistency and empirical support for health-care decision-making.

Purpose of the Study:

  • To establish a protocol for SEE to inform health-care decision-making.
  • To clarify methods for collecting and using expert judgments, consider alternative methodologies, establish preferred elicitation approaches, and determine how experts can express uncertainty.

Main Methods:

  • A mixed-methods approach including systematic review, targeted searches, and experimental work.
  • Review of existing SEE guidelines to identify approaches and a set of principles for health-care decision-making.
  • Development and applied evaluation of a reference protocol for SEE.

Main Results:

  • Inconsistency and lack of empirical evidence were found across existing SEE guidelines.
  • A reference protocol for health technology assessment (HTA) was defined, emphasizing expert selection, elicitation of observable quantities, and individual belief elicitation.
  • Adaptations for non-HTA contexts and limited expert access (e.g., group discussion) are noted.

Conclusions:

  • The developed reference protocol for structured expert elicitation is flexible and applicable across different health-care decision-making settings.
  • Further applied studies are needed to evaluate the protocol's choices in practice.