经济评估结果受到参数输入对应关系的重大影响
Erin Barker1, Harriet Fewster1, Karina Watts1
1York Health Economics Consortium, University of York, York, North Yorkshire, UK.
概括
概率灵敏度分析 (PSA) 需要仔细考虑参数相关性. 忽视相关性可能导致成本效益确定性的不准确估计,影响决策.
科学领域:
- 卫生经济学 卫生经济学
- 决策科学 决策科学 决策科学
- 统计建模 统计建模
背景情况:
- 概率敏感性分析 (PSA) 对于量化成本效益分析 (CEA) 中的不确定性至关重要.
- 输入参数相关性对PSA结果的影响往往被低估或遗漏.
- 这种监督可能导致CEA错误估计不确定性和错误的结论.
研究的目的:
- 开发一种简化模型来评估输入参数相关性对增量成本效益比率 (ICER) 的影响.
- 评估相关性对干预措施具有成本效益的概率的影响.
- 为了突出考虑PSA中的参数间相关性的重要性.
主要方法:
- 开发一个马尔科夫模型,结合三个相关性场景:没有,部分和完美.
- 利用一个假设的案例研究来证明每个相关性方法的影响.
- 场景分析的应用,以确保在不同条件下发现的可靠性.
主要成果:
- 在不同相关性假设中,增量成本效益比 (ICER) 仍然相对一致.
- 决策结果的确定性程度差异很大,没有相关性产生最确定的结果,完美的相关性产生最少.
- 由于ICER与支付意愿值的接近,它调节了相关性对PSA结果的影响.
结论:
- 在PSA中用于建模参数相关性的方法显著影响模型输出的确定性.
- 如果不考虑参数之间的相关性,可能会导致成本效益确定性的高估或低估.
- 研究人员和决策者必须仔细考虑PSA参数相关性对可靠经济评估的影响.
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