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Economic evaluation in schistosomiasis: using the Delphi technique to assess effectiveness
1Department of Community Health, University of Cape Town, South Africa.
Acta Tropica
|April 15, 1997
Summary
Limited resources in Kenya necessitate prioritizing schistosomiasis control interventions. This study used a modified Delphi approach to estimate the health impact (expected quality adjusted life years) of interventions, highlighting the need for systematic decision-making.
Area of Science:
- Public Health
- Health Economics
- Decision Analysis
Background:
- Schistosomiasis Control Programme in Kenya faces resource limitations, hindering the implementation of all effective interventions.
- A multi-faceted approach to schistosomiasis eradication is advocated, but resource constraints necessitate prioritization based on cost-benefit analysis.
- Estimating the health impact (quality and quantity of life) is crucial for prioritizing health interventions.
Purpose of the Study:
- To identify data needs for estimating schistosomiasis intervention impacts on health status.
- To develop and test an instrument for obtaining subjective probabilistic impacts of interventions.
- To establish a framework for estimating intervention impacts and calculating expected quality adjusted life years (EQALY).
Main Methods:
- A modified Delphi approach was employed to gather subjective judgments from experts on the effectiveness of ten schistosomiasis interventions.
- Expert subjective judgments were used to estimate the expected quality adjusted life years (EQALY) for various interventions.
- The study compared EQALY estimates derived from local Kenyan experts with those from a foreign expert.
Main Results:
- Panelists showed consistency in ranking the relative effectiveness of treatment versus non-treatment schistosomiasis interventions.
- Significant discrepancies were observed in the magnitude of EQALY estimates between local and foreign experts.
- The modified Delphi technique demonstrated potential for systematic decision analysis in resource-limited settings.
Conclusions:
- Systematic decision analysis using techniques like the modified Delphi can improve resource allocation for schistosomiasis control in Kenya.
- Policy-makers should consider expert subjective judgments, while acknowledging potential biases, for evidence-based decision-making.
- Adopting such methods offers a more rational approach compared to traditional reliance on past practices or intuition.