Abstract
In the face of constrained budgets, unavoidable decisions about the use of health care interventions have to be made. Decision makers seeking to maximise health for their given budget should use the best available information on effectiveness and cost-effectiveness, and for this purpose they may use a process of gathering and combining existing evidence in this context called Health Technology Assessment (HTA). In informing decisions, utilising HTA, expert elicitation can provide valuable information, particularly where evidence is missing, where it may not be as well developed (e.g. diagnostics, medical devices, early access to medicines scheme or public health) or limited (insufficient, not very relevant, contradictory and/or flawed). Here, formal methods to elicit expert judgements are preferred to improve the accountability and transparency of the decision making process, in addition to the important role in reducing bias and the use of heuristics. There have been a limited number of applications of expert elicitation in health care decision making, and in part this may be due to a number of methodological uncertainties regarding the applicability and transferability of techniques from other disciples, such as Bayesian statistics and engineering, to health care. This chapter discusses the distinguishing features of health care decision making and the use of expert elicitation to inform this, drawing on applied examples in the area illustrating some of the complexities and uncertainties.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Babuscia A, Cheung KM (2014) An approach to perform expert elicitation for engineering design risk analysis: methodology and experimental results. J R Stat Soc 177(2):475–497
Briggs AH (1999) A Bayesian approach to stochastic cost-effectiveness analysis. Health Econ 8(3):257–261
Bryan S, Williams I, McIver S (2007) Seeing the NICE side of cost-effectiveness analysis: a qualitative investigation of the use of CEA in NICE technology appraisals. Health Econ 16(2):179–193
Claxton K (1999) The irrelevance of inference: a decision-making approach to the stochastic evaluation of health care technologies. J Health Econ 18(3):341–364
Cooke RM (1991) Experts in Uncertainty. Oxford University Press, Oxford
Culyer AJ, Wagstaff A (1993) Equity and equality in health and health care. J Health Econ 12:431–458
Drummond M, Sculpher MJ, Torrance JW, O’Brien BJ, Stoddart GL (2005) Methods for the economic evaluation of health care programmes, 3rd edn. Oxford University Press, Oxford
European Food Safety Authority (2014) Guidance on expert knowledge elicitation in food and feed safety risk assessment. EFSA J 12(6):3734. http://onlinelibrary.wiley.com/doi/10.2903/j.efsa.2014.3734/epdf
Expert Judgement Network (2016) Selection of structured expert judgement software. http://www.expertsinuncertainty.net/Software/tabid/4149/Default.aspx. Accessed 05 June 2017
Folland S, Goodman AC, Stano M (2013) The economics of health and healthcare, 7th edn. Routledge, New York
Gigerenzer G, Hoffrage U (1995) How to improve Bayesian reasoning without instruction: frequency formats. Psychol Rev 102(4):684
Gosling JP (2014) Methods for eliciting expert opinion to inform health technology assessment. Medical Research Council. https://www.mrc.ac.uk/documents/pdf/methods-for-eliciting-expert-opinion-gosling-2014/. Accessed 05 June 2017
Gosling JP (2018) SHELF: the Sheffield elicitation framework. In: Dias LC, Morton A, Quigley J (eds) Elicitation: the science and art of structuring judgment. Springer, New York. (Chapter 4 in this book)
Griffin S, Claxton K, Palmer SJ, Sculpher MJ (2011) Dangerous omissions: the consequences of ignoring decision uncertainty. Health Econ 20(2):212–224
Grigore B, Peters J, Hyde C, Stein K (2016) A comparison of two methods for expert elicitation in health technology assessments. BMC Med Res Methodol 16:85
Grigore B, Peters J, Hyde C, Stein K (2013) Methods to elicit probability distributions from experts: a systematic review of reported practice in health technology assessment. PharmacoEconomics 31(11):991–1003
Haakma W, Steuten LM, Bojke L, IJzerman MJ (2014) Belief elicitation to populate health economic models of medical diagnostic devices in development. Appl Health Econ Health Policy 12(3):327–334
Iglesias CPTA, Rogowski WH, Payne K (2016) Reporting guidelines for the use of expert judgement in model-based economic evaluations. PharmacoEconomics 34(11):1161–1172
Morris DE, Oakley JE, Crowe JA (2014) A web-based tool for eliciting probability distributions from experts. Environ Model Softw 52:1–4
O’Hagan A, Buck CE, Daneshkhah A, Eiser JR, Garthwaite PH, David J, Jenkinson DJ, Oakley JE, Rakow T (2006) Uncertain judgements: eliciting experts’ probabilities. Wiley, Chichester
Romanow RJQ (2002) Building on values: the future of health care in Canada, Final Report
Sculpher MJ, Claxton K, Drummond M, Mccabe C (2006) Whither trial-based economic evaluation for health care decision making? Health Econ 15(7):677–687
Soares MO, Bojke L, Dumville J, Iglesias C, Cullum N, Claxton K (2011) Methods to elicit experts’ beliefs over uncertain quantities: application to a cost effectiveness transition model of negative pressure wound therapy for severe pressure ulceration. Stat Med 30(19):2363–2380
Soares MODJ, Ashby R, Iglesias C, Bojke L, Adderley U (2013) Methods to assess cost effectiveness and value of further research when data are sparse: negative pressure wound therapy for severe pressure ulcers. Med Decis Mak 33(3):415–436
Soares MO, Dumville JC, Ades AE, Welton NJ (2014) Treatment comparisons for decision making: facing the problems of sparse and few data. J R Stat Soc 177(1):259–279
Sullivan W, Payne K (2011) The appropriate elicitation of expert opinion in economic models. PharmacoEconomics 29(6):455–459
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Soares, M.O., Bojke, L. (2018). Expert Elicitation to Inform Health Technology Assessment. In: Dias, L., Morton, A., Quigley, J. (eds) Elicitation. International Series in Operations Research & Management Science, vol 261. Springer, Cham. https://doi.org/10.1007/978-3-319-65052-4_18
Download citation
DOI: https://doi.org/10.1007/978-3-319-65052-4_18
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-65051-7
Online ISBN: 978-3-319-65052-4
eBook Packages: Business and ManagementBusiness and Management (R0)