Articlebronze2001

BAYESIAN VALUE-OF-INFORMATION ANALYSIS

Karl Claxton · Peter J. Neumann · Sally S. Araki · Milton C. Weinstein

186 citations0/0 files storedInternational Journal of Technology Assessment in Health Care

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Health Systems, Economic Evaluations, Quality of Life Economic and Environmental Valuation Advanced Causal Inference Techniques

Abstract

A framework is presented that distinguishes the conceptually separate decisions of which treatment strategy is optimal from the question of whether more information is required to inform this choice in the future. The authors argue that the choice of treatment strategy should be based on expected utility, and the only valid reason to characterize the uncertainty surrounding outcomes of interest is to establish the value of acquiring additional information. A Bayesian decision theoretic approach is demonstrated through a probabilistic analysis of a published policy model of Alzheimer's disease. The expected value of perfect information is estimated for the decision to adopt a new pharmaceutical for the population of patients with Alzheimer's disease in the United States. This provides an upper bound on the value of additional research. The value of information is also estimated for each of the model inputs. This analysis can focus future research by identifying those parameters where more precise estimates would be most valuable and indicating whether an experimental design would be required. We also discuss how this type of analysis can also be used to design experimental research efficiently (identifying optimal sample size and optimal sample allocation) based on the marginal cost and marginal benefit of sample information. Value-of-information analysis can provide a measure of the expected payoff from proposed research, which can be used to set priorities in research and development. It can also inform an efficient regulatory framework for new healthcare technologies: an analysis of the value of information would define when a claim for a new technology should be deemed substantiated and when evidence should be considered competent and reliable when it is not cost-effective to gather any more information.

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References

1993Markov Models in Medical Decision Making 1969Decision Analysis: Introductory Lectures on Choices Under Uncertainty.1966Information Value Theory 1969Decision Analysis: Introductory Lectures on Choices Under Uncertainty.1996Multiattribute Utility Function for a Comprehensive Health Status Classification System 1999The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies 1985Probabilistic Sensitivity Analysis Using Monte Carlo Simulation 1997Economic foundations of cost-effectiveness analysis

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