“…To this figure, an annual discount rate of 4% was applied over a 10-year time horizon of the technology, assumed to be the period during which 4 the information is relevant to inform the decision. The EVPPI requires two-level Monte Carlo simulation [24], beginning with an outer loop (100) sampling values from the distribution of the parameters of interest, and an inner loop (1000) sampling the remaining parameters from their conditional distribution [44]. The parameters groups of interests were determined based on the type of study design required for further research: 1) RCT to inform the tp, 2) QoL survey to provide further information regarding utility weights associated with chemotherapy and breast cancer health-states, 3) longitudinal costing study to provide more information on resource use of the tests, the chemotherapy and the health-states, and 4) longitudinal study to provide more information on the biomarkers' prevalence, PPVs, and the TRRs of biomarker negative and TNBC patients [24].…”