Problem Structuring in Economic Evaluation

Rita Faria

doi:10.1093/acrefore/9780190625979.013.108

Problem Structuring in Economic Evaluation

Rita Faria

Centre for Health Economics

Research output: Chapter in Book/Report/Conference proceeding › Chapter

Abstract

Economic evaluation provides a framework to help inform decisions on which technologies represent the best use of healthcare resources (i.e. are cost-effective) by bringing together the available evidence about the benefits and costs of the alternative options. Critical to the economic evaluation framework is the need to accurately characterise the decision problem – this is the problem structuring stage. Problem structuring encompasses the characterisation of the target population; identification of the decisions options to compare in the model (e.g. using the technology in different ways, standard of care, others); and the development of the conceptual model, which maps out how the decision options relate to the costs and benefits in the target population. Problem structuring is central to the application of the economic evaluation framework and to development of the analysis, as it determines the specific questions that can be addressed and affects the relevance and credibility of the results. The methodological guidelines discuss problem structuring to some extent, although the practical implications warrant further consideration. With respect to the target population, questions emerge about how to define the target population, whether and which sources of heterogeneity to consider, and when and in whom to consider spillovers. Relating to the specification of decision options, about how to identify and select relevant decision options, including restricting the comparison to standard of care, sequences of tests and/or treatments and do-nothing approaches. There are also issues relating to the role and the process of development of the conceptual model. Based on a review of methodological guidelines and reflections on their implications, various recommendations for practice emerge. The process of developing the conceptual model, and how to use it to inform choices and assumptions in the economic evaluation are two areas where further research is warranted.

Original language	English
Title of host publication	Oxford Research Encyclopedia of Economics and Finance
Publisher	Oxford University Press
DOIs	https://doi.org/10.1093/acrefore/9780190625979.013.108
Publication status	E-pub ahead of print - 23 Feb 2021

Bibliographical note

© Oxford University Press 2021.This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.

Access to Document

10.1093/acrefore/9780190625979.013.108

Faria_Problem_Structuring_in_Economic_Evaluation_CLEAN_POST_ED_APPROVAL_11092020
© Oxford University Press 2021.This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.
Accepted author manuscript, 215 KB

Cite this

@inbook{1be6972d84ae41f7b21da32cc74c0d5f,

title = "Problem Structuring in Economic Evaluation",

abstract = "Economic evaluation provides a framework to help inform decisions on which technologies represent the best use of healthcare resources (i.e. are cost-effective) by bringing together the available evidence about the benefits and costs of the alternative options. Critical to the economic evaluation framework is the need to accurately characterise the decision problem – this is the problem structuring stage. Problem structuring encompasses the characterisation of the target population; identification of the decisions options to compare in the model (e.g. using the technology in different ways, standard of care, others); and the development of the conceptual model, which maps out how the decision options relate to the costs and benefits in the target population. Problem structuring is central to the application of the economic evaluation framework and to development of the analysis, as it determines the specific questions that can be addressed and affects the relevance and credibility of the results. The methodological guidelines discuss problem structuring to some extent, although the practical implications warrant further consideration. With respect to the target population, questions emerge about how to define the target population, whether and which sources of heterogeneity to consider, and when and in whom to consider spillovers. Relating to the specification of decision options, about how to identify and select relevant decision options, including restricting the comparison to standard of care, sequences of tests and/or treatments and do-nothing approaches. There are also issues relating to the role and the process of development of the conceptual model. Based on a review of methodological guidelines and reflections on their implications, various recommendations for practice emerge. The process of developing the conceptual model, and how to use it to inform choices and assumptions in the economic evaluation are two areas where further research is warranted. ",

author = "Rita Faria",

note = "{\textcopyright} Oxford University Press 2021.This is an author-produced version of the published paper. Uploaded in accordance with the publisher{\textquoteright}s self-archiving policy. Further copying may not be permitted; contact the publisher for details.This is an author-produced version of the published paper. Uploaded in accordance with the publisher{\textquoteright}s self-archiving policy. Further copying may not be permitted; contact the publisher for details. ",

year = "2021",

month = feb,

day = "23",

doi = "10.1093/acrefore/9780190625979.013.108",

language = "English",

booktitle = "Oxford Research Encyclopedia of Economics and Finance",

publisher = "Oxford University Press",

address = "United Kingdom",

}

TY - CHAP

T1 - Problem Structuring in Economic Evaluation

AU - Faria, Rita

N1 - © Oxford University Press 2021.This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.

PY - 2021/2/23

Y1 - 2021/2/23

N2 - Economic evaluation provides a framework to help inform decisions on which technologies represent the best use of healthcare resources (i.e. are cost-effective) by bringing together the available evidence about the benefits and costs of the alternative options. Critical to the economic evaluation framework is the need to accurately characterise the decision problem – this is the problem structuring stage. Problem structuring encompasses the characterisation of the target population; identification of the decisions options to compare in the model (e.g. using the technology in different ways, standard of care, others); and the development of the conceptual model, which maps out how the decision options relate to the costs and benefits in the target population. Problem structuring is central to the application of the economic evaluation framework and to development of the analysis, as it determines the specific questions that can be addressed and affects the relevance and credibility of the results. The methodological guidelines discuss problem structuring to some extent, although the practical implications warrant further consideration. With respect to the target population, questions emerge about how to define the target population, whether and which sources of heterogeneity to consider, and when and in whom to consider spillovers. Relating to the specification of decision options, about how to identify and select relevant decision options, including restricting the comparison to standard of care, sequences of tests and/or treatments and do-nothing approaches. There are also issues relating to the role and the process of development of the conceptual model. Based on a review of methodological guidelines and reflections on their implications, various recommendations for practice emerge. The process of developing the conceptual model, and how to use it to inform choices and assumptions in the economic evaluation are two areas where further research is warranted.

AB - Economic evaluation provides a framework to help inform decisions on which technologies represent the best use of healthcare resources (i.e. are cost-effective) by bringing together the available evidence about the benefits and costs of the alternative options. Critical to the economic evaluation framework is the need to accurately characterise the decision problem – this is the problem structuring stage. Problem structuring encompasses the characterisation of the target population; identification of the decisions options to compare in the model (e.g. using the technology in different ways, standard of care, others); and the development of the conceptual model, which maps out how the decision options relate to the costs and benefits in the target population. Problem structuring is central to the application of the economic evaluation framework and to development of the analysis, as it determines the specific questions that can be addressed and affects the relevance and credibility of the results. The methodological guidelines discuss problem structuring to some extent, although the practical implications warrant further consideration. With respect to the target population, questions emerge about how to define the target population, whether and which sources of heterogeneity to consider, and when and in whom to consider spillovers. Relating to the specification of decision options, about how to identify and select relevant decision options, including restricting the comparison to standard of care, sequences of tests and/or treatments and do-nothing approaches. There are also issues relating to the role and the process of development of the conceptual model. Based on a review of methodological guidelines and reflections on their implications, various recommendations for practice emerge. The process of developing the conceptual model, and how to use it to inform choices and assumptions in the economic evaluation are two areas where further research is warranted.

U2 - 10.1093/acrefore/9780190625979.013.108

DO - 10.1093/acrefore/9780190625979.013.108

M3 - Chapter

BT - Oxford Research Encyclopedia of Economics and Finance

PB - Oxford University Press

ER -