Authors' objectives:

This study had the following objectives: - To identify and describe published guidelines for assessing the quality of decision-analytic models in health technology assessment. - To develop a synthesised guideline and accompanying checklist using available good practice guidelines. - To provide guidance on key theoretical, methodological and practical issues not yet covered in published guidelines. Two areas were identified in advance as priorities: literature searching for parameter estimation in decision models, and adjusting for bias in treatment effect estimates from observational studies used in decision models. - To consider the implications of this research for what might be expected of future decision-analytic models relating to the National Institute for Clinical Excellence (NICE) technology appraisal process and health technology assessment in general.

Authors' recommendations: The review of current guidelines showed that although authors may provide a consistent message regarding some aspects of modelling, in other areas conflicting attributes are presented in different guidelines. A preliminary assessment showed that, in general, the checklist appears to perform well, in terms of identifying those aspects of the model that should be of particular concern to the reader. The checklist cannot, however, provide answers to the appropriateness of the model structure and structural assumptions, as these may be seen as a general problem with generic checklists and do not reflect any shortcoming with the synthesised guidance and checklist developed here. The assessment of the checklist, as well as feedback from the EAG, indicated the importance of its use in conjunction with a more general checklist or guidelines on economic evaluation. The review of current guidance for good quality decision-analytic modelling for health technology assessment highlighted a number of methodological areas that have not received attention in the literature on good practice. There are a lot of these areas and, therefore, it was only possible to consider two specific methods areas in decision modelling: the identification of parameter estimates from published literature, and the issue of adjusting treatment effect estimates taken from observational studies for potential bias. Literature reviews showed that both of these areas are under-researched and are areas in which further research is needed.

Authors' methods: Systematic review, economic modelling

Project Status: Completed

URL for project: http://www.hta.ac.uk/1342

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk

Copyright: 2009 Queen's Printer and Controller of HMSO