Universität zu Köln

Mueller, Dirk, Pullenayegum, Eleanor ORCID: 0000-0003-4265-1330 and Gandjour, Afschin (2015). Impact of small study bias on cost-effectiveness acceptability curves and value of information analyses. Eur. J. Health Econ., 16 (2). S. 219 - 224. NEW YORK: SPRINGER. ISSN 1618-7601

Full text not available from this repository.

Abstract

It is well known that small, randomized, controlled trials (RCTs) have limited validity. When comparing the results of meta-analyses with those of later large trials or with those of large trials removed from the meta-analyses, discrepancies were reported. This paper addresses two issues: (1) how measures of the uncertainty in cost-effectiveness, i.e., cost-effectiveness acceptability curves (CEACs), and the expected value of perfect information (EVPI) are affected by the limited validity of small trials and (2) how to deal with this bias. To this end, the paper adopts a Bayesian approach. Using empirical estimates for the validity of small RCTs compared to larger RCTs, the probability of cost-effectiveness drops by almost 10 %, while the EVPI is three times higher. In conclusion, traditional CEACs and EVPI analyses based on (small) RCTs may need careful appraisal. Ignoring prior evidence on the validity of small-size trials leads to an underestimation of uncertainty in cost-effectiveness. For future economic analyses, it is important to incorporate aspects of uncertainty which are caused by flawed data on effectiveness .

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mueller, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Pullenayegum, Eleanor UNSPECIFIED orcid.org/0000-0003-4265-1330 UNSPECIFIED Gandjour, Afschin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-406273
DOI:	10.1007/s10198-014-0607-3
Journal or Publication Title:	Eur. J. Health Econ.
Volume:	16
Number:	2
Page Range:	S. 219 - 224
Date:	2015
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1618-7601
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEALTH-CARE; METAANALYSES; PUBLICATION; LIMITATIONS; INFERENCE; THERAPY; TRIALS; MODEL Multiple languages Economics; Health Policy & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40627