Suen Sze-chuan, Goldhaber-Fiebert Jeremy D
Department of Management Science and Engineering, Stanford University Stanford, CA, USA (SS)
Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA (JDG-F).
Med Decis Making. 2016 Jan;36(1):132-6. doi: 10.1177/0272989X15583496. Epub 2015 Apr 29.
Cost-effectiveness analysis aims to identify treatments and policies that maximize benefits subject to resource constraints. However, the conventional process of identifying the efficient frontier (i.e., the set of potentially cost-effective options) can be algorithmically inefficient, especially when considering a policy problem with many alternative options or when performing an extensive suite of sensitivity analyses for which the efficient frontier must be found for each. Here, we describe an alternative one-pass algorithm that is conceptually simple, easier to implement, and potentially faster for situations that challenge the conventional approach. Our algorithm accomplishes this by exploiting the relationship between the net monetary benefit and the cost-effectiveness plane. To facilitate further evaluation and use of this approach, we also provide scripts in R and Matlab that implement our method and can be used to identify efficient frontiers for any decision problem.
成本效益分析旨在确定在资源限制条件下使效益最大化的治疗方法和政策。然而,确定有效前沿(即一组潜在的成本效益选项)的传统过程在算法上可能效率低下,特别是在考虑有许多替代选项的政策问题时,或者在进行一系列广泛的敏感性分析时,每种分析都必须找到有效前沿。在这里,我们描述了一种替代的单遍算法,该算法概念简单,易于实现,并且在挑战传统方法的情况下可能更快。我们的算法通过利用净货币效益与成本效益平面之间的关系来实现这一点。为了便于对该方法进行进一步评估和使用,我们还提供了R和Matlab脚本,这些脚本实现了我们的方法,可用于识别任何决策问题的有效前沿。