Araki Daiji, Kamae Isao
Division of Medical Statistics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Graduate School of Public Policy, The University of Tokyo, Japan.
Kobe J Med Sci. 2015 Mar 24;61(1):E9-18.
New schemes on the cost-effectiveness acceptability curve (CEAC) were developed, which can make the CEAC augmented to be more informative regarding the types of acceptance and statistical inference. Theoretical approaches have been undertaken to address two questions: 1) how the area under the curve (AUC) can be zoned by different types of acceptance displayed on the incremental cost-effectiveness plane, and 2) how the accepted dataset of incremental cost-effectiveness ratios (ICERs), which are generated by simulation runs, can be statistically associated with a threshold of ICER for acceptance. To address the first question, the AUC of a typically sigmoid-shaped CEAC was divided into three zones according to the three segmentations of the scattered plots accepted at South-east, North-east and South-west quadrants on the incremental cost-effectiveness plane. A solution for the second question was "a new CEAC of the mean" (mCEAC), which is defined by plotting a pair of the mean and its occurrence probability of ICER accepted at North-east quadrant on the incremental cost-effectiveness plane. All those schemes were graphically illustrated based on hypothetical examples using the bootstrapping simulation. Our new schemes on CEAC will provide decision makers with useful information on cost-effectiveness assessment beyond the standard presentation of CEAC.
开发了成本效益可接受性曲线(CEAC)的新方案,这些方案可使CEAC得到扩充,从而在接受类型和统计推断方面提供更多信息。已采用理论方法来解决两个问题:1)如何根据增量成本效益平面上显示的不同接受类型对曲线下面积(AUC)进行分区,以及2)通过模拟运行生成的增量成本效益比(ICER)的接受数据集如何与接受的ICER阈值进行统计关联。为了解决第一个问题,根据增量成本效益平面上东南、东北和西南象限接受的散点图的三种分割方式,将典型S形CEAC的AUC分为三个区域。第二个问题的解决方案是“均值的新CEAC”(mCEAC),它通过在增量成本效益平面上绘制东北象限接受的ICER的均值及其出现概率对来定义。所有这些方案都基于使用自举模拟的假设示例进行了图形说明。我们关于CEAC的新方案将为决策者提供超出CEAC标准呈现的成本效益评估有用信息。