ARE VALUE OF INFORMATION METHODS READY FOR PRIME TIME? AN APPLICATION TO ALTERNATIVE TREATMENT STRATEGIES FOR NSTEMI PATIENTS

Objectives: The use of value of information methods to inform trial design has been widely advocated but there have been few empirical applications of these methods and there is little evidence they are widely used in decision making. This study considers the usefulness of value of information models in the context of a real clinical decision problem relating to alternative diagnostic strategies for patients with a recent non-ST elevated myocardial infarction. Methods: A pretrial economic model is constructed to consider the cost-effectiveness of two competing strategies: coronary angiography alone or in conjunction with fractional flow reserve measurement. A closed-form solution to the expected benefits of information is used with optimal sample size estimated for a range of models reflecting increasingly realistic assumptions and alternative decision contexts. Results: Fractional flow reserve measurement is expected to be cost-effective with an incremental cost-effectiveness ratio of GBP 1,621, however, there is considerable uncertainty in this estimate and consequently a large expected value to reducing this uncertainty via a trial. The recommended sample size is strongly affected by the reality of the assumptions of the expected value of information (EVI) model and the decision context. Conclusions: Value of information models can provide a simple and flexible approach to clinical trial design and are more consistent with the constraints and objectives of the healthcare system than traditional frequentist approaches. However, the variation in sample size estimates demonstrates that it is essential that appropriate model parameters and decision contexts are used in their application.

• Publication year

  2013

• Venue

  International Journal of Technology Assessment in Health Care

• Publication date

  2013-10-01

• Fields of study

  Medicine, Economics

• Identifiers
  DOI 10.1017/S0266462313000433PMID 24290337PMCID 3846382
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• The Value of Value of Information

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  2010cited by this paper
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  2009cited by this paper
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  2009cited by this paper
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  2009cited by this paper
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  2009cited by this paper
• Time and expected value of sample information wait for no patient.

  2008cited by this paper
• Expected value of information and decision making in HTA.

  2007cited by this paper
• Physiological assessment of coronary artery disease in the cardiac catheterization laboratory: a scientific statement from the American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology.

  2006cited by this paper
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  2005cited by this paper
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  2004cited by this paper
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  2000cited by this paper
• A Behavioral Bayes Method for Determining the Size of a Clinical Trial

  2000cited by this paper
• The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies.

  1999cited by this paper
• British National Formulary

  1994cited by this paper
• Methods for the economic evaluation of health care programmes

  1987cited by this paper
• Coronary heart disease

  1957influential reference

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  2023cites this paper
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  2022cites this paper
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  2022cites this paper
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  2018cites this paper
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  2017cites this paper
• Physiome approach for the analysis of vascular flow reserve in the heart and brain

  2017cites this paper
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  2017cites this paper
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  2017cites this paper
• Non-invasive versus invasive management in patients with prior coronary artery bypass surgery with a non-ST segment elevation acute coronary syndrome: study design of the pilot randomised controlled trial and registry (CABG-ACS)

  2016cites this paper
• Sample Size Estimation for Non-Inferiority Trials: Frequentist Approach versus Decision Theory Approach

  2015cites this paper
• Better Informing Decision Making with Multiple Outcomes Cost-Effectiveness Analysis under Uncertainty in Cost-Disutility Space

  2015cites this paper
• Computing Expected Value of Partial Sample Information from Probabilistic Sensitivity Analysis Using Linear Regression Metamodeling

  2015cites this paper
• Pharmaceutical policy in Australia : developing methods to manage uncertainty in health technology assessment

  2015cites this paper
• Estimating the Expected Value of Sample Information Using the Probabilistic Sensitivity Analysis Sample

  2015cites this paper
• Fractional flow reserve (FFR) versus angiography in guiding management to optimise outcomes in non-ST segment elevation myocardial infarction (FAMOUS-NSTEMI) developmental trial: cost-effectiveness using a mixed trial- and model-based methods

  2015cites this paper