Methods to assess cost-effectiveness and value of further research when data are sparse: negative-pressure wound therapy for severe pressure ulcers

Soares, Marta O., Dumville, Jo C., Ashby, Rebecca L., Iglesias, Cynthia P., Bojke, Laura, Adderley, Una, McGinnis, Elizabeth, Stubbs, Nikki, Torgerson, David J., Claxton, Karl and Cullum, Nicola (2013) Methods to assess cost-effectiveness and value of further research when data are sparse: negative-pressure wound therapy for severe pressure ulcers. Medical Decision Making, 33 3: 415-436. doi:10.1177/0272989X12451058


Author Soares, Marta O.
Dumville, Jo C.
Ashby, Rebecca L.
Iglesias, Cynthia P.
Bojke, Laura
Adderley, Una
McGinnis, Elizabeth
Stubbs, Nikki
Torgerson, David J.
Claxton, Karl
Cullum, Nicola
Title Methods to assess cost-effectiveness and value of further research when data are sparse: negative-pressure wound therapy for severe pressure ulcers
Journal name Medical Decision Making   Check publisher's open access policy
ISSN 0272-989X
1552-681X
Publication date 2013-04-01
Year available 2012
Sub-type Article (original research)
DOI 10.1177/0272989X12451058
Volume 33
Issue 3
Start page 415
End page 436
Total pages 22
Place of publication Thousand Oaks, CA, United States
Publisher Sage Publications
Language eng
Formatted abstract
Health care resources are scarce, and decisions have to be made about how to allocate funds. Often, these decisions are based on sparse or imperfect evidence. One such example is negative-pressure wound therapy (NPWT), which is a widely used treatment for severe pressure ulcers; however, there is currently no robust evidence that it is effective or cost-effective. This work considers the decision to adopt NPWT given a range of alternative treatments, using a decision analytic modeling approach. Literature searches were conducted to identify existing evidence on model parameters. Given the limited evidence base, a second source of evidence, beliefs elicited from experts, was used. Judgments from experts on relevant (uncertain) quantities were obtained through a formal elicitation exercise. Additionally, data derived from a pilot trial were also used to inform the model. The 3 sources of evidence were collated, and the impact of each on cost-effectiveness was evaluated. An analysis of the value of further information indicated that a randomized controlled trial may be worthwhile in reducing decision uncertainty, where from a set of alternative designs, a 3-arm trial with longer follow-up was estimated to be the most efficient. The analyses presented demonstrate how allocation decisions about medical technologies can be explicitly informed when data are sparse and how this kind of analyses can be used to guide future research prioritization, not only indicating whether further research is worthwhile but what type of research is needed and how it should be designed.
Keyword Markov model
Elicited evidence
Pilot trial
Negative pressure wound therapy
Sparse
Evidence synthesis
Expected value of information
Research design
Cost-effectiveness analysis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Published online before print August 27, 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Nursing, Midwifery and Social Work Publications
 
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Created: Thu, 22 May 2014, 19:21:51 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work