Division of Population Health, Health Services Research and Primary Care, Manchester Centre for Health Economics, The University of Manchester, Oxford Road, Manchester, M139PL, UK.
GRAIL, New Penderel House 4th Floor, 283-288 High Holborn, London, WC1V 7HP, UK.
Appl Health Econ Health Policy. 2024 Jul;22(4):527-542. doi: 10.1007/s40258-024-00887-z. Epub 2024 May 16.
Decision-makers require knowledge of the strengths and weaknesses of decision-analytic models used to evaluate healthcare interventions to be able to confidently use the results of such models to inform policy. A number of aspects of model validity have previously been described, but no systematic approach to assessing the validity of a model has been proposed. This study aimed to consolidate the different aspects of model validity into a step-by-step approach to assessing the strengths and weaknesses of a decision-analytic model.
A pre-defined set of steps were used to conduct the validation process of an exemplar early decision-analytic-model-based cost-effectiveness analysis of a risk-stratified national breast cancer screening programme [UK healthcare perspective; lifetime horizon; costs (£; 2021)]. Internal validation was assessed in terms of descriptive validity, technical validity and face validity. External validation was assessed in terms of operational validation, convergent validity (or corroboration) and predictive validity.
The results outline the findings of each step of internal and external validation of the early decision-analytic-model and present the validated model (called 'MANC-RISK-SCREEN'). The positive aspects in terms of meeting internal validation requirements are shown together with the remaining limitations of MANC-RISK-SCREEN.
Following a transparent and structured validation process, MANC-RISK-SCREEN has been shown to have satisfactory internal and external validity for use in informing resource allocation decision-making. We suggest that MANC-RISK-SCREEN can be used to assess the cost-effectiveness of exemplars of risk-stratified national breast cancer screening programmes (NBSP) from the UK perspective.
A step-by-step process for conducting the validation of a decision-analytic model was developed for future use by health economists. Using this approach may help researchers to fully demonstrate the strengths and limitations of their model to decision-makers.
决策者需要了解用于评估医疗干预措施的决策分析模型的优缺点，以便能够有信心地使用这些模型的结果来为政策提供信息。之前已经描述了模型有效性的许多方面，但尚未提出评估模型有效性的系统方法。本研究旨在将模型有效性的不同方面整合到一个逐步评估决策分析模型的优缺点的方法中。
使用预定义的步骤来对一个基于早期决策分析模型的风险分层国家乳腺癌筛查计划的成本效益分析进行验证过程[英国医疗保健视角；终生；成本（£；2021 年]。内部验证是根据描述性有效性、技术有效性和表面有效性来评估的。外部验证是根据操作性验证、收敛有效性（或证实）和预测有效性来评估的。
结果概述了内部和外部验证早期决策分析模型的每一步的发现，并呈现了经过验证的模型（称为“MANC-RISK-SCREEN”）。展示了满足内部验证要求的积极方面，以及 MANC-RISK-SCREEN 的剩余局限性。
经过透明和结构化的验证过程，MANC-RISK-SCREEN 已被证明具有令人满意的内部和外部有效性，可用于为资源分配决策提供信息。我们建议，从英国的角度来看，可以使用 MANC-RISK-SCREEN 来评估风险分层国家乳腺癌筛查计划（NBSP）的成本效益。
为健康经济学家开发了一个用于对决策分析模型进行验证的逐步过程。使用这种方法可以帮助研究人员向决策者充分展示他们模型的优缺点。
