Briggs A, Sculpher M, Buxton M
Health Economics Research Group, Brunel University, Uxbridge, UK.
Health Econ. 1994 Mar-Apr;3(2):95-104. doi: 10.1002/hec.4730030206.
Given the increased use of economic evaluation to inform decision making in the health service, it is particularly important that the research methods used are critically assessed and, where possible, improved. The systematic handling of uncertainty in economic evaluation is an important area that remains methodologically underdeveloped. With the increased use of the clinical trial as a vehicle for economic evaluation, there has been recent interest in how the statistical methods routinely employed to handle uncertainty in clinical research might be applied to economic evaluation. This paper reviews the types of uncertainty that exist in economic evaluation and argues that some forms of uncertainty are not amenable to statistical methods. Sensitivity analysis is not a single approach but can take a number of different forms. The different types of sensitivity analysis are reviewed, with an indication of their strengths and weaknesses in relation to the different types of uncertainty in economic evaluation.
鉴于在卫生服务决策中越来越多地使用经济评估，对所采用的研究方法进行严格评估并在可能的情况下加以改进尤为重要。经济评估中不确定性的系统处理是一个重要领域，在方法学上仍不够完善。随着临床试验作为经济评估手段的使用增加，最近人们对如何将临床研究中常规用于处理不确定性的统计方法应用于经济评估产生了兴趣。本文回顾了经济评估中存在的不确定性类型，并认为某些形式的不确定性不适用于统计方法。敏感性分析不是单一的方法，而是可以采取多种不同形式。本文回顾了不同类型的敏感性分析，并指出了它们在处理经济评估中不同类型不确定性方面的优缺点。
