Reference Case Methods for Expert Elicitation in Health Care Decision Making.

Area of Science:

• Health Economics
• Decision Sciences
• Biostatistics

Background:

• Health care decision making (HCDM) often relies on uncertain evidence.
• Expert judgment is crucial for navigating uncertainty in HCDM.
• Structured expert elicitation (elicitation) quantifies expert beliefs, but methodologies vary.

Purpose of the Study:

• To establish reference case methods for expert elicitation in HCDM.
• To assess the suitability of existing elicitation methodologies for HCDM.
• To provide guidance for health technology assessment (HTA) decision-making.

Main Methods:

• Systematic review and critique of existing elicitation methods.
• Controlled experiments to evaluate the accuracy of alternative elicitation techniques.
• Development of principles for elicitation in HCDM to guide method selection.

Main Results:

• A significant lack of empirical evidence supports many current elicitation method recommendations.
• Reference case methods for HTA prioritize experts with direct observational knowledge and individual belief elicitation over consensus.
• Existing guidelines may not be fully appropriate for HCDM.

Conclusions:

• A reference case for elicitation in HTA is defined, adaptable to different decision-making contexts.
• Further research is needed on applied examples and comparative experimental evidence of elicitation methods.
• Additional considerations for elicitation may exist beyond HTA.