Research prioritization using value of information analysis: initial experiences in the US

The expected value of information (VOI) approach is a method designed to prioritize limited health research funds by identifying areas where additional data collection would reduce the likelihood that a suboptimal intervention would be adopted into clinical practice, or conversely that a high value intervention would not be adopted.  At its core, VOI utilizes decision analysis and principles of economic evaluation in generating research priorities. Many thought leaders in the United States recognize the intuitive appeal of VOI. Nevertheless, their enthusiasm has been tempered by concerns regarding (1) the complexity and apparent lack of transparency of the VOI method and (2) VOIs use of cost-effectiveness analysis as a method for health resource allocation. In this discussion, I will outline some of the principles of VOI and its potential applications in the US healthcare research enterprise. I will then address current barriers and propose methods for overcoming those barriers. I will illustrate these issues with an adaptation of the VOI process that we have proposed for a large cancer cooperative clinical trials group in the United States.