Using Expert Elicitation to Adjust Published Intervention Effects to Reflect the Local Context.

Area of Science:

• Health services research
• Health economics
• Clinical decision-making

Background:

• Local health services underutilize economic evaluations for funding new interventions.
• A key barrier is the limited relevance of published intervention effects to local contexts.
• Published effect estimates often reflect the original evaluation setting, not local realities.

Purpose of the Study:

• To explore the use of expert elicitation to adjust published intervention effects for local economic evaluations.
• To increase the local relevance of economic evaluations for health service funding decisions.
• To assess the feasibility and acceptability of expert elicitation methods.

Main Methods:

• Expert elicitation involving 6 clinical experts.
• Systematic presentation of differences between published study and local contexts (patient characteristics, quality of care, implementation scope).
• Experts estimated realistic, pessimistic, and optimistic intervention effect sizes for the local setting.

Main Results:

• Experts estimated both interventions would be less effective locally than in published studies.
• Reduced effectiveness was linked to lower patient complexity and differences in implementation scope (hospital-wide vs. targeted).
• The elicitation process provided adjusted effect estimates for local economic evaluations.

Conclusions:

• Pragmatic expert elicitation is a feasible and acceptable method for adjusting published intervention effects.
• This adjustment enhances the local relevance of economic evaluations.
• Further development and application of these methods are recommended to support local decision-making.