School of Medicine and Population Health, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK.
Delta Hat, Nottingham, UK.
Pharmacoeconomics. 2024 Dec;42(12):1317-1327. doi: 10.1007/s40273-024-01425-4. Epub 2024 Aug 29.
Survival extrapolation often plays an important role in health technology assessment (HTA), and there are a range of different approaches available. Approaches that can leverage external evidence (i.e. data or information collected outside the main data source of interest) may be helpful, given the extent of uncertainty often present when determining a suitable survival extrapolation. One of these methods is the multi-parameter evidence synthesis (MPES) approach, first proposed for use in HTA by Guyot et al., and more recently by Jackson. While MPES has potential benefits over conventional extrapolation approaches (such as simple or flexible parametric models), it is more computationally complex and requires use of specialist software. This tutorial presents an introduction to MPES for HTA, alongside a user-friendly, publicly available operationalisation of Guyot's original MPES that can be executed using the statistical software package R. Through two case studies, both Guyot's and Jackson's MPES approaches are explored, along with sensitivity analyses relevant to HTA. Finally, the discussion section of the tutorial details important considerations for analysts considering use of an MPES approach, along with potential further developments. MPES has not been used often in HTA, and so there are limited examples of how it has been used and perceived. However, this tutorial may aid future research efforts exploring the use of MPES further.
生存外推在卫生技术评估（HTA）中经常起着重要作用，并且有多种不同的方法可供选择。鉴于在确定合适的生存外推时常常存在很大的不确定性，因此利用外部证据（即从主要感兴趣数据源之外收集的数据或信息）的方法可能会有所帮助。其中一种方法是多参数证据综合（MPES）方法，该方法最初由 Guyot 等人提出用于 HTA，最近由 Jackson 提出。虽然 MPES 相对于传统的外推方法（如简单或灵活的参数模型）具有潜在的优势，但它的计算更为复杂，需要使用专业软件。本教程介绍了用于 HTA 的 MPES，并提供了 Guyot 最初的 MPES 的用户友好型、公开可用的操作化版本，可使用统计软件包 R 执行该操作化版本。通过两个案例研究，探索了 Guyot 和 Jackson 的 MPES 方法以及与 HTA 相关的敏感性分析。最后，本教程的讨论部分详细介绍了考虑使用 MPES 方法的分析师需要考虑的重要问题，以及可能的进一步发展。MPES 在 HTA 中尚未得到广泛应用，因此关于其使用和看法的例子有限。但是，本教程可能有助于进一步探索使用 MPES 的未来研究工作。
