School of Health and Related Research, University of Sheffield, Sheffield, UK.
Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK.
Pharmacoeconomics. 2017 Nov;35(11):1113-1121. doi: 10.1007/s40273-017-0553-x.
Health economic evaluation is a framework for the comparative analysis of the incremental health gains and costs associated with competing decision alternatives. The process of developing health economic models is usually complex, financially expensive and time-consuming. For these reasons, model development is sometimes based on previous model-based analyses; this endeavour is usually referred to as model replication. Such model replication activity may involve the comprehensive reproduction of an existing model or 'borrowing' all or part of a previously developed model structure. Generally speaking, the replication of an existing model may require substantially less effort than developing a new de novo model by bypassing, or undertaking in only a perfunctory manner, certain aspects of model development such as the development of a complete conceptual model and/or comprehensive literature searching for model parameters. A further motivation for model replication may be to draw on the credibility or prestige of previous analyses that have been published and/or used to inform decision making. The acceptability and appropriateness of replicating models depends on the decision-making context: there exists a trade-off between the 'savings' afforded by model replication and the potential 'costs' associated with reduced model credibility due to the omission of certain stages of model development. This paper provides an overview of the different levels of, and motivations for, replicating health economic models, and discusses the advantages, disadvantages and caveats associated with this type of modelling activity. Irrespective of whether replicated models should be considered appropriate or not, complete replicability is generally accepted as a desirable property of health economic models, as reflected in critical appraisal checklists and good practice guidelines. To this end, the feasibility of comprehensive model replication is explored empirically across a small number of recent case studies. Recommendations are put forward for improving reporting standards to enhance comprehensive model replicability.
健康经济评价是一种用于比较分析与竞争决策方案相关的增量健康收益和成本的框架。开发健康经济模型的过程通常是复杂的，费用昂贵且耗时。由于这些原因，模型开发有时基于以前的基于模型的分析；这种努力通常被称为模型复制。这种模型复制活动可能涉及全面复制现有的模型，或者“借用”以前开发的模型结构的全部或部分。一般来说，通过绕过或仅以敷衍的方式进行模型开发的某些方面，例如完整概念模型的开发和/或模型参数的全面文献搜索，复制现有模型可能需要的工作量要大大少于开发全新的从头开始的模型。复制现有模型的另一个动机可能是利用以前已发表并/或用于为决策提供信息的分析的可信度或声誉。复制模型的可接受性和适当性取决于决策背景：模型复制提供的“节省”与由于省略了模型开发的某些阶段而导致的模型可信度降低的潜在“成本”之间存在权衡。本文概述了复制健康经济模型的不同层次和动机，并讨论了这种建模活动的优缺点和注意事项。无论复制模型是否应被视为合适，完整的可复制性通常被认为是健康经济模型的理想属性，这反映在批判性评估清单和良好实践指南中。为此，通过对少量最近的案例研究进行实证研究，探讨了全面复制模型的可行性。提出了改进报告标准的建议，以提高全面模型的可复制性。
