Assessing the costs and benefits of medical research: The diabetic retinopathy study

Systematic review on costs and resource use of randomized clinical trials shows a lack of transparent and comprehensive data

“…One observation in our study was that some of the oldest RCTs were very costly (i.e. USD 61 Mio [79], USD 77 Mio [81], USD 367 Mio and USD 611 Mio [80]; Table 4), which is in contrast to the existing opinion that RCT costs are on constant rise [12,14,16,88]. However, one has to be aware that all findings of this systematic review could be substantially affected by publication bias (i.e.…”

Systematic review on costs and resource use of randomized clinical trials shows a lack of transparent and comprehensive data

“…One observation in our study was that some of the oldest RCTs were very costly (i.e. USD 61 Mio [79], USD 77 Mio [81], USD 367 Mio and USD 611 Mio [80]; Table 4), which is in contrast to the existing opinion that RCT costs are on constant rise [12,14,16,88]. However, one has to be aware that all findings of this systematic review could be substantially affected by publication bias (i.e.…”

The role of modelling in prioritising and planning clinical trials

“…Three of the case studies were retrospective, and these only consider the actual trial because the trial was already complete at the time of the analysis of the payback from research. [88][89][90] These retrospective analyses show the importance of covering all possibilities, for example, the diabetic retinopathy study 90 has a relatively complex result, where the technology is effective for one patient subgroup but results are inconclusive for two other subgroups. The Detsky formulation, 89 undertaken on seven different trials, is the most sophisticated in its assessment of delta results as it allows for different sizes of delta result (in this case mortality risk reduction) rather than just positive or negative.…”

“…For the diabetic retinopathy trial, the health benefits were estimated using a decision tree approach. 90 The sensitivity analysis in the diabetic retinopathy trial showed that the value of the trial was significantly affected by its assumed effectiveness in subgroups where inconclusive results had been discovered. Even in this retrospective analysis, a significant factor in the calculation of the trial's value (i.e.…”

Prioritisation of health technology assessment. The PATHS model: methods and case studies

“…[16][17][18][19][20][21][22][23][24][25] Other papers did not include an appropriate model but some had relevant material that informed the analysis and critique of the models, and are referred to subsequently in discussion.…”

Systematic review on costs and resource use of randomized clinical trials shows a lack of transparent and comprehensive data

“…One observation in our study was that some of the oldest RCTs were very costly (i.e. USD 61 Mio [79], USD 77 Mio [81], USD 367 Mio and USD 611 Mio [80]; Table 4), which is in contrast to the existing opinion that RCT costs are on constant rise [12,14,16,88]. However, one has to be aware that all findings of this systematic review could be substantially affected by publication bias (i.e.…”

The role of modelling in prioritising and planning clinical trials

“…Three of the case studies were retrospective, and these only consider the actual trial because the trial was already complete at the time of the analysis of the payback from research. [88][89][90] These retrospective analyses show the importance of covering all possibilities, for example, the diabetic retinopathy study 90 has a relatively complex result, where the technology is effective for one patient subgroup but results are inconclusive for two other subgroups. The Detsky formulation, 89 undertaken on seven different trials, is the most sophisticated in its assessment of delta results as it allows for different sizes of delta result (in this case mortality risk reduction) rather than just positive or negative.…”

“…For the diabetic retinopathy trial, the health benefits were estimated using a decision tree approach. 90 The sensitivity analysis in the diabetic retinopathy trial showed that the value of the trial was significantly affected by its assumed effectiveness in subgroups where inconclusive results had been discovered. Even in this retrospective analysis, a significant factor in the calculation of the trial's value (i.e.…”

Prioritisation of health technology assessment. The PATHS model: methods and case studies

“…[16][17][18][19][20][21][22][23][24][25] Other papers did not include an appropriate model but some had relevant material that informed the analysis and critique of the models, and are referred to subsequently in discussion.…”

Systematic review on costs and resource use of randomized clinical trials shows a lack of transparent and comprehensive data

“…One observation in our study was that some of the oldest RCTs were very costly (i.e. USD 61 Mio [79], USD 77 Mio [81], USD 367 Mio and USD 611 Mio [80]; Table 4), which is in contrast to the existing opinion that RCT costs are on constant rise [12,14,16,88]. However, one has to be aware that all findings of this systematic review could be substantially affected by publication bias (i.e.…”

The role of modelling in prioritising and planning clinical trials

“…Three of the case studies were retrospective, and these only consider the actual trial because the trial was already complete at the time of the analysis of the payback from research. [88][89][90] These retrospective analyses show the importance of covering all possibilities, for example, the diabetic retinopathy study 90 has a relatively complex result, where the technology is effective for one patient subgroup but results are inconclusive for two other subgroups. The Detsky formulation, 89 undertaken on seven different trials, is the most sophisticated in its assessment of delta results as it allows for different sizes of delta result (in this case mortality risk reduction) rather than just positive or negative.…”

“…For the diabetic retinopathy trial, the health benefits were estimated using a decision tree approach. 90 The sensitivity analysis in the diabetic retinopathy trial showed that the value of the trial was significantly affected by its assumed effectiveness in subgroups where inconclusive results had been discovered. Even in this retrospective analysis, a significant factor in the calculation of the trial's value (i.e.…”

Prioritisation of health technology assessment. The PATHS model: methods and case studies

“…[16][17][18][19][20][21][22][23][24][25] Other papers did not include an appropriate model but some had relevant material that informed the analysis and critique of the models, and are referred to subsequently in discussion.…”