Faculty of Medicine, McGill University, Montreal, Canada; Evidera, Lexington, MA, USA.
Archimedes, Inc., San Francisco, CA, USA.
Value Health. 2014 Mar;17(2):174-82. doi: 10.1016/j.jval.2014.01.003.
The evaluation of the cost and health implications of agreeing to cover a new health technology is best accomplished using a model that mathematically combines inputs from various sources, together with assumptions about how these fit together and what might happen in reality. This need to make assumptions, the complexity of the resulting framework, the technical knowledge required, as well as funding by interested parties have led many decision makers to distrust the results of models. To assist stakeholders reviewing a model's report, questions pertaining to the credibility of a model were developed. Because credibility is insufficient, questions regarding relevance of the model results were also created. The questions are formulated such that they are readily answered and they are supplemented by helper questions that provide additional detail. Some responses indicate strongly that a model should not be used for decision making: these trigger a "fatal flaw" indicator. It is hoped that the use of this questionnaire, along with the three others in the series, will help disseminate what to look for in comparative effectiveness evidence, improve practices by researchers supplying these data, and ultimately facilitate their use by health care decision makers.
评估同意涵盖新医疗技术的成本和健康影响，最好使用一种模型来完成，该模型将来自不同来源的投入进行数学组合，并对这些投入如何组合以及在现实中可能会发生什么做出假设。这种需要做出假设、由此产生的框架的复杂性、所需的技术知识以及利益相关方的资金支持，导致许多决策者不信任模型的结果。为了帮助审查模型报告的利益相关者，开发了与模型可信度相关的问题。由于可信度不足，还创建了与模型结果相关性相关的问题。这些问题的制定方式使其易于回答，并附有提供更多详细信息的辅助问题。一些回答强烈表明不应使用模型做出决策：这些回答触发了“致命缺陷”指标。希望使用该问卷以及该系列中的其他三个问卷，将有助于传播在比较有效性证据中需要注意的问题，改进提供这些数据的研究人员的实践，并最终促进医疗保健决策者对其的使用。
