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Addressing adoption and research decisions: the value of sample information and alternative research designs in EECP

Thursday 11 November 2010, 1.30PM

Speaker(s): Claire McKenna, CHE

Abstract - Using a model of enhanced external counterpulsation (EECP) for the treatment of angina, expert elicitation and value of sample information were combined into a single coherent framework to establish the value of further research and the optimal design of such research.  The expected value of sample information (EVSI) was compared to the costs of sampling and the expected net benefit of sample information (ENBS) was obtained.  The ENBS provides a measure of the societal payoff to research and a sufficient condition for deciding to conduct more research.  Given the need to establish if EECP has a role for treating angina and the paucity of effectiveness evidence available, the ENBS was used to determine the type of study required, the optimal sample size, the appropriate length of follow-up and the endpoints that should be included. 

In this presentation, we carefully distinguish the impact that the research decision is expected to have on different groups of patients who accrue different net benefits in different time periods: patients who are incident after the research reports, patients who are enrolled in the research and patients not enrolled but prevalent while the research is conducted.  We also explore the implications for research design of approving the technology for widespread use or withholding the technology from approval until the research is conducted.  In doing so we highlight the impact of irrecoverable opportunity costs when the initial costs of a technology are only compensated by later gains in health outcome. 

 

Location: Alcuin A Block A019/A020

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Economic evaluation seminar dates

  • 17 March 2011 (Please note change of start time 2.30pm)
    Pedro Saramago Goncalves, CHE
  • 27 April 2011
    Mike Paulden, University of Toronto