Olariu Elena, Cadwell Kevin K, Hancock Elizabeth, Trueman David, Chevrou-Severac Helene
PHMR Ltd, London, UK.
Takeda Pharmaceuticals International AG, Zurich, Switzerland.
Clinicoecon Outcomes Res. 2017 Sep 1;9:537-546. doi: 10.2147/CEOR.S135445. eCollection 2017.
Although Markov cohort models represent one of the most common forms of decision-analytic models used in health care decision-making, correct implementation of such models requires reliable estimation of transition probabilities. This study sought to identify consensus statements or guidelines that detail how such transition probability matrices should be estimated.
A literature review was performed to identify relevant publications in the following databases: Medline, Embase, the Cochrane Library, and PubMed. Electronic searches were supplemented by manual-searches of health technology assessment (HTA) websites in Australia, Belgium, Canada, France, Germany, Ireland, Norway, Portugal, Sweden, and the UK. One reviewer assessed studies for eligibility.
Of the 1,931 citations identified in the electronic searches, no studies met the inclusion criteria for full-text review, and no guidelines on transition probabilities in Markov models were identified. Manual-searching of the websites of HTA agencies identified ten guidelines on economic evaluations (Australia, Belgium, Canada, France, Germany, Ireland, Norway, Portugal, Sweden, and UK). All identified guidelines provided general guidance on how to develop economic models, but none provided guidance on the calculation of transition probabilities. One relevant publication was identified following review of the reference lists of HTA agency guidelines: the International Society for Pharmacoeconomics and Outcomes Research taskforce guidance. This provided limited guidance on the use of rates and probabilities.
There is limited formal guidance available on the estimation of transition probabilities for use in decision-analytic models. Given the increasing importance of cost-effectiveness analysis in the decision-making processes of HTA bodies and other medical decision-makers, there is a need for additional guidance to inform a more consistent approach to decision-analytic modeling. Further research should be done to develop more detailed guidelines on the estimation of transition probabilities.
尽管马尔可夫队列模型是医疗保健决策中使用的最常见的决策分析模型形式之一，但正确实施此类模型需要可靠地估计转移概率。本研究旨在确定详细说明应如何估计此类转移概率矩阵的共识声明或指南。
进行文献综述，以在以下数据库中识别相关出版物：医学索引数据库（Medline）、荷兰医学文摘数据库（Embase）、考科蓝图书馆和美国国立医学图书馆生物医学期刊数据库（PubMed）。通过手动搜索澳大利亚、比利时、加拿大、法国、德国、爱尔兰、挪威、葡萄牙、瑞典和英国的卫生技术评估（HTA）网站来补充电子搜索。一名评审员评估研究的 eligibility。
在电子搜索中识别出的1931条引用中，没有研究符合全文审查的纳入标准，也未识别出关于马尔可夫模型中转移概率的指南。对HTA机构网站的手动搜索识别出了十条关于经济评估的指南（澳大利亚、比利时、加拿大、法国、德国、爱尔兰、挪威、葡萄牙、瑞典和英国）。所有识别出的指南都提供了关于如何开发经济模型的一般指导，但没有一个提供关于转移概率计算的指导。在审查HTA机构指南的参考文献列表后，识别出一篇相关出版物：国际药物经济学和结果研究协会特别工作组指南。这对比率和概率的使用提供了有限的指导。
关于用于决策分析模型的转移概率估计的正式指导有限。鉴于成本效益分析在HTA机构和其他医疗决策者的决策过程中日益重要，需要额外的指导，以采用更一致的方法进行决策分析建模。应开展进一步研究，以制定关于转移概率估计的更详细指南。
