Cohen Joshua T, Wong John B
*Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center †Department of Medicine, Division of Clinical Decision Making, Tufts Medical Center, Boston, MA.
Med Care. 2017 Nov;55(11):912-914. doi: 10.1097/MLR.0000000000000811.
To enhance the credibility and the value of health economic analyses, we argue that the computer model source code underlying these analyses should be made publicly available. Only with open publication is it possible for others to assess whether alternative assumptions, beyond those examined by the model authors, alter the model's findings. Because reproducibility is critical for scientific acceptance and because computation increasingly permeates scientific inquiry, other fields have moved toward open publication of computer models, and health economics should avoid falling behind. Making source code available shines a light on these otherwise black boxes and facilitates their complete evaluation and understandability. The preceding commentary makes 2 arguments against open publication. It claims first that open publication would undermine intellectual property rights and discourage work in this field. We respond that the impact on intellectual property would be minimal, and that open publication could even increase model value. The second argument against open publication is the possibility of model misuse. If anything, however, open publication would reduce this risk by making the model implementation completely transparent. We argue finally that open publication of models would have ancillary benefits by making the research more amenable for adaptation and innovation. Moving toward open publication will present challenges, but we believe that the benefits of increased scientific credibility and utility, particularly for health policy and clinical practice decisions, will certainly outweigh the harms.
为提高卫生经济分析的可信度和价值，我们认为应公开这些分析所基于的计算机模型源代码。只有通过公开出版，其他人才能评估除模型作者所考察的假设之外的其他假设是否会改变模型的结果。由于可重复性对于科学认可至关重要，且计算在科学探究中日益普及，其他领域已朝着计算机模型的公开出版迈进，卫生经济学应避免落后。公开源代码能让这些原本像黑匣子一样的模型暴露在阳光下，便于对其进行全面评估和理解。之前的评论提出了两条反对公开出版的理由。首先，它声称公开出版会损害知识产权并阻碍该领域的研究工作。我们回应称，对知识产权的影响将微乎其微，而且公开出版甚至可能增加模型的价值。反对公开出版的第二个理由是模型可能被滥用。然而，恰恰相反，公开出版会通过使模型实施完全透明来降低这种风险呢。我们最后指出，模型的公开出版将带来附带好处，使研究更易于被改编和创新。迈向公开出版会带来挑战，但我们相信，提高科学可信度和实用性所带来的益处，尤其是对卫生政策和临床实践决策而言，肯定会超过危害。
