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Urdu“Healthcare decision making, including regulatory and reimbursement decisions, is typically grounded in uncertain assessments of clinical and economic value,” said author Maarten IJzerman, PhD, Professor of Cancer Health Services Research, Erasmus School of Health Policy & Management, Rotterdam, The Netherlands. “Structured expert elicitation is the process of extracting expert knowledge about uncertain quantity or quantities and formulating that information into probability distributions. It is very useful for decision modeling and support, particularly in areas with limited evidence, such as advanced therapy products, precision medicine, rare diagnoses, and other areas with high uncertainty. These protocols also provide structured, pre-defined approaches that are important for transparency and reproducibility.”
Because no prescriptive guidance for the use of structured expert elicitation has been previously available, this ISPOR Good Practices Report provides an overview of formal elicitation methods to support a range of healthcare decision making processes across an array of settings. This report focuses on 5 protocols and compares them on the level of elicitation, mode of aggregation, and level of interaction.
Key highlights:
- The report examines the following protocols:
- SHeffield ELicitation Framework (SHELF)
- Modified Delphi method
- Cooke’s classical method
- Investigate, Discuss, Estimate, Aggregate (IDEA) protocol
- Medical Research Council (MRC) reference protocol
- It outlines the strengths and limitations of each protocol across economic, political, scientific, social, and equity dimensions relevant to healthcare decision making.
- It provides recommendations on which protocols may be most suitable for specified settings, such as time-constrained decisions, early-stage technology assessments, and public health policies.
- It emphasizes the importance of transparency in reporting structured expert elicitation methods and results.
“Structured expert elicitation is a valuable tool for extracting expert knowledge about an uncertain quantity and formulating that knowledge as a probability distribution,” noted IJzerman. “This creates a useful input to decision modeling and support, particularly in areas with limited evidence, such as advanced therapy products, precision medicine, rare diagnoses, and other areas with high uncertainty. The recommendations made here regarding choice of structured expert elicitation protocol should help to prepare decision makers in navigating the different steps they must take to allow structured expert elicitation to be conducted efficiently, effectively, and consistently.”
About ISPOR’s Task Force on Structured Expert Elicitation for Healthcare Decision Making
Objective:
The primary objective is to provide an introduction to formal elicitation methods to support a range of healthcare decision making processes, across a range of settings. This emerging good practice guidance will fill a gap in guidance on the use of expert elicitation in a wide range of decision and modeling contexts.
Rationale:
The evidence used to establish cost-effectiveness and inform healthcare decision making is typically uncertain. With a less developed (and often a limited) evidence-base, judgments based on consultation with individuals who have expertise on the subject matter, can be vital. However, in the absence of definitive evidence, experts are likely to be uncertain about their beliefs. A process to capture their beliefs should reflect this. To improve accountability and consistency within healthcare decision making processes, it is desirable that these judgments are made explicit, using a formal and structured process. There is a lack of both clear guidance and empirical studies comparing methods. Click here to learn more.
Suggested Reading:
- Multistakeholder Perceptions of Additional Value Elements for United States Value Assessment of Health Interventions
- Content of Health Economics Analysis Plans (HEAPs) for Trial-Based Economic Evaluations: Expert Delphi Consensus Survey
- Ranking the Criteria Used in the Appraisal of Drugs for Reimbursement: A Stated Preferences Elicitation With Health Technology Assessment Stakeholders Across Jurisdictional Contexts
- Experiences of Structured Elicitation for Model-Based Cost-Effectiveness Analyses
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ABOUT ISPOR
ISPOR—The Professional Society for Health Economics and Outcomes Research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.
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ABOUT VALUE IN HEALTH
Value in Health (ISSN 1098-3015) is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions. The journal’s current impact factor score is 4.9 and its 5-year impact factor score is 5.6. Value in Health is ranked 5th of 118 journals in Health Policy and Services, 15th of 174 journals in Health Care Sciences and Services, and 56th of 597 journals in Economics. Value in Health is a monthly publication that circulates to more than 55,000 readers around the world.
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ABOUT ISPOR GOOD PRACTICES REPORTS
ISPOR has earned an international reputation for research excellence based, in part, on its Good Practices Reports. These highly cited reports are expert consensus recommendations on good practice standards for outcomes research (clinical, economic, and patient-reported outcomes) and on the use of this research in healthcare decision making. ISPOR Task Forces comprise subject matter experts representing different stakeholders from diverse work environments (i.e., regulators, payers, manufacturers, technology assessors, etc. from research, government, academic, and industry sectors around the world). All ISPOR Good Practices Reports are published in the Society’s scientific journal, Value in Health, and are made freely available as part of the Society’s mission. The Society’s Good Practices Reports have been recognized with an ASAE “Power of A” award that acknowledges innovative, effective, and broad-reaching programs that have a positive impact on the world.
