The Half-Life of Truth: What Are Appropriate Time Horizons for Research Decisions?

Purpose. To evaluate alternative approaches taken to estimate the population that could benefit from research and to demonstrate that explicitly modeling future change leads to more appropriate estimates of the expected value of information (EVI). Methods. Existing approaches to estimating the population typically focus on the time horizon for decisions, employing seemingly arbitrary estimates of the appropriate horizon. These approaches implicitly use the time horizon as a proxy for future changes in technologies, prices, and information. Different approaches to quantifying the time horizon are explored, in the context of a stylized model, to demonstrate the impact of uncertainty in this estimate on EVI. An alternative approach is developed that explicitly models future changes in technologies, prices, and information and that demonstrates the impact on EVI estimates. Results. Explicitly modeling future changes means that the EVI for the decision problem may increase or decrease over time, but the EVI for the group of parameters that can be evaluated by current research tends to decline. The finite and infinite time horizons for the decision problem represent special cases (e.g., price shock or no changes, respectively). This type of analysis can be used to inform policy decisions relating to the timing of research. Conclusions. The value of information depends on future changes in technologies, prices, and evidence. Finite time horizons for decision problems can be seen as a proxy for the complex and uncertain process of future change. A more explicit approach to modeling these changes could provide a more appropriate basis for calculating EVI, but this raises a number of significant methodological and technical challenges.

[1]  John D. Graham,et al.  Going beyond the single number: Using probabilistic risk assessment to improve risk management , 1996 .

[2]  M Sculpher,et al.  A pilot study on the use of decision theory and value of information analysis as part of the NHS Health Technology Assessment programme. , 2004, Health technology assessment.

[3]  A A Stinnett,et al.  Net Health Benefits , 1998, Medical decision making : an international journal of the Society for Medical Decision Making.

[4]  Kimberly M. Thompson,et al.  The Value of Improved National Exposure Information for Perchloroethylene (Perc): A Case Study for Dry Cleaners , 1997 .

[5]  Andrew R Willan,et al.  Expected value of information and decision making in HTA. , 2007, Health economics.

[6]  James O. Berger Statistical Decision Theory , 1980 .

[7]  H. Raiffa,et al.  Applied Statistical Decision Theory. , 1961 .

[8]  Julien Taieb,et al.  Truth Survival in Clinical Research: An Evidence-Based Requiem? , 2002, Annals of Internal Medicine.

[9]  K Claxton,et al.  The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies. , 1999, Journal of health economics.

[10]  A E Ades,et al.  Expected Value of Sample Information Calculations in Medical Decision Modeling , 2004, Medical decision making : an international journal of the Society for Medical Decision Making.

[11]  M. Sculpher,et al.  Decision Modelling for Health Economic Evaluation , 2006 .

[12]  Fumie Yokota,et al.  Value of Information Literature Analysis: A Review of Applications in Health Risk Management , 2004, Medical decision making : an international journal of the Society for Medical Decision Making.

[13]  Ronald A. Howard,et al.  Information Value Theory , 1966, IEEE Trans. Syst. Sci. Cybern..

[14]  Alan Brennan,et al.  Efficient computation of partial expected value of sample information using Bayesian approximation. , 2007, Journal of health economics.

[15]  C. Platell,et al.  Half-life of truth in surgical literature , 1997, The Lancet.

[16]  Gordon B. Hazen,et al.  Sensitivity Analysis and the Expected Value of Perfect Information , 1998, Medical decision making : an international journal of the Society for Medical Decision Making.

[17]  James K. Hammitt,et al.  Research Planning for Food Safety , 1989 .

[18]  S. Palmer,et al.  Incorporating option values into the economic evaluation of health care technologies. , 2000, Journal of health economics.

[19]  Laura Bojke,et al.  Priority setting for research in health care: An application of value of information analysis to glycoprotein IIb/IIIa antagonists in non-ST elevation acute coronary syndrome , 2006, International Journal of Technology Assessment in Health Care.

[20]  Karl Claxton,et al.  A Pilot Study of Value of Information Analysis to Support Research Recommendations for NICE , 2005 .

[21]  Karl Claxton,et al.  Establishing the cost-effectiveness of new pharmaceuticals under conditions of uncertainty--when is there sufficient evidence? , 2005, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[22]  Howard Raiffa,et al.  Decision analysis: introductory lectures on choices under uncertainty. 1968. , 1969, M.D.Computing.

[23]  P Tappenden,et al.  Methods for expected value of information analysis in complex health economic models: developments on the health economics of interferon-beta and glatiramer acetate for multiple sclerosis. , 2004, Health technology assessment.

[24]  M. Weinstein,et al.  Taking account of future technology in cost effectiveness analysis , 2004, BMJ : British Medical Journal.

[25]  Stephen E. Palmera,et al.  A COST-EFFECTIVENESS MODEL COMPARING ALTERNATIVE MANAGEMENT STRATEGIES FOR THE USE OF GLYCOPROTEIN IIB / IIIA ANTAGONISTS IN NON-ST-ELEVATION ACUTE CORONARY SYNDROME , 2007 .

[26]  K Claxton,et al.  An economic approach to clinical trial design and research priority-setting. , 1996, Health economics.

[27]  Stacy A. Johnson,et al.  A COST-EFFECTIVENESS MODEL COMPARING ALTERNATIVE MANAGEMENT STRATEGIES FOR THE USE OF GLYCOPROTEIN IIB/IIIA ANTAGONISTS IN NON-ST- ELEVATION ACUTE CORONARY SYNDROME , 2007 .