Health Economics and Health Technology Assessment (HEHTA), School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK.
Health Policy and Administration Department, Faculty of Public Health, University of Indonesia, Depok, Indonesia.
BMC Health Serv Res. 2024 Sep 13;24(1):1060. doi: 10.1186/s12913-024-11559-y.
Decision models are increasingly used to inform policy-making processes, and there is a need to improve their credibility. The estimation of health and economic outcomes generated from decision models is influenced by the development process itself. This paper aims to present the conceptual model development process of cardiometabolic disease (CMD) policy models in the UK setting.
This conceptual model followed the International Society of Pharmacoeconomics and Outcomes Research-Society of Medical Decision Making (ISPOR-SMDM) Modelling Good Research Practices Task Force-2.
First, for the conceptualisation of the problem, the CMD disease staging, progression and current clinical guidelines were summarised, followed by a systematic review of published policy models. We critically appraised policy models such as cardiovascular disease and type 2 diabetes. Key messages from the review emphasised the importance of understanding various determinants influencing model development, including risk factors, model structure, models' parameters, data utilisation, economic perspective, equality/equity consideration, transparency and validation process. Second, as a sequential process, is model conceptualisation, to determine which modelling types and their attributes best represent the defined problem. Expert opinions, including a clinician and experienced modellers, provided input on the state transition model to ensure the structure is clinically relevant. From this stage, the consideration and agreement to establish a disease state in a state transition model was discussed.
This conceptual model serves as a basis for representing the systematic process for structuring a CMD policy model to enhance its transparency and credibility.
决策模型越来越多地被用于为决策过程提供信息,因此需要提高其可信度。决策模型产生的健康和经济结果的估计受到其开发过程本身的影响。本文旨在介绍英国心血管代谢疾病(CMD)政策模型的概念模型开发过程。
本概念模型遵循国际药物经济学与结果研究学会-医学决策制定学会(ISPOR-SMDM)模型良好研究实践工作组 2 的建议。
首先,为了对问题进行概念化,对 CMD 疾病分期、进展和当前临床指南进行了总结,随后对已发表的政策模型进行了系统评价。我们对心血管疾病和 2 型糖尿病等政策模型进行了批判性评估。综述中的关键信息强调了理解影响模型开发的各种决定因素的重要性,包括风险因素、模型结构、模型参数、数据利用、经济视角、平等/公平考虑、透明度和验证过程。其次,作为一个连续的过程,模型概念化用于确定哪种建模类型及其属性最能代表所定义的问题。临床医生和经验丰富的建模者等专家意见为状态转移模型提供了输入,以确保结构具有临床相关性。从这个阶段开始,就建立状态转移模型中的疾病状态进行了考虑和达成一致。
本概念模型为构建 CMD 政策模型提供了一个基础,以提高其透明度和可信度。