Useof Expert Knowledge Elicitation to Estimate Parameters in Health Economic Decision Models

Hadorn, David C.; Kvizhinadze, Giorgi; Collinson, Lucie; Blakely, Tony

doi:10.1017/s0266462314000427

Cited by 16 publications

(7 citation statements)

References 15 publications

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“…The advantage of our approach is therefore that it faithfully represents expert uncertainty. Indeed, a recent review of health economics studies indicates that expert uncertainty is rarely quantified as robustly as we have done here [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

The Health Equity and Effectiveness of Policy Options to Reduce Dietary Salt Intake in England: Policy Forecast

et al. 2015

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BackgroundPublic health action to reduce dietary salt intake has driven substantial reductions in coronary heart disease (CHD) over the past decade, but avoidable socio-economic differentials remain. We therefore forecast how further intervention to reduce dietary salt intake might affect the overall level and inequality of CHD mortality.MethodsWe considered English adults, with socio-economic circumstances (SEC) stratified by quintiles of the Index of Multiple Deprivation. We used IMPACTSEC, a validated CHD policy model, to link policy implementation to salt intake, systolic blood pressure and CHD mortality. We forecast the effects of mandatory and voluntary product reformulation, nutrition labelling and social marketing (e.g., health promotion, education). To inform our forecasts, we elicited experts’ predictions on further policy implementation up to 2020. We then modelled the effects on CHD mortality up to 2025 and simultaneously assessed the socio-economic differentials of effect.ResultsMandatory reformulation might prevent or postpone 4,500 (2,900–6,100) CHD deaths in total, with the effect greater by 500 (300–700) deaths or 85% in the most deprived than in the most affluent. Further voluntary reformulation was predicted to be less effective and inequality-reducing, preventing or postponing 1,500 (200–5,000) CHD deaths in total, with the effect greater by 100 (−100–600) deaths or 49% in the most deprived than in the most affluent. Further social marketing and improvements to labelling might each prevent or postpone 400–500 CHD deaths, but minimally affect inequality.ConclusionsMandatory engagement with industry to limit salt in processed-foods appears a promising and inequality-reducing option. For other policy options, our expert-driven forecast warns that future policy implementation might reach more deprived individuals less well, limiting inequality reduction. We therefore encourage planners to prioritise equity.

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Section: Discussionmentioning

confidence: 99%

The Health Equity and Effectiveness of Policy Options to Reduce Dietary Salt Intake in England: Policy Forecast

et al. 2015

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“…Expert elicitation is increasingly used in health services research and health technology assessment as a means to obtain fair estimates of parameters that are difficult or even impossible to measure, often due to a structural lack of data . The assessment of the costs of transfusion reactions is an exemplary illustration for such an application.…”

Section: Discussionmentioning

confidence: 99%

Direct costs of transfusion reactions – an expert judgement approach

Janssen

Tilborgh²,

Vooght

et al. 2017

Vox Sanguinis

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“…Expert knowledge is a valuable source of information, as becomes evident in the quote of Drescher. Hadorn et al (2014) found that 57% of health economic decision models included at least one expert knowledge elicitation parameter, showing that in some fields it is even the norm to use expert elicitation. More examples of elicitation practices in many different fields can be found in overview studies by O’Hagan et al (2006 , chap.…”

Section: Introductionmentioning

confidence: 99%

Proposal for a Five-Step Method to Elicit Expert Judgment

Veen

Stoel²,

Zondervan‐Zwijnenburg

et al. 2017

Front. Psychol.

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Elicitation is a commonly used tool to extract viable information from experts. The information that is held by the expert is extracted and a probabilistic representation of this knowledge is constructed. A promising avenue in psychological research is to incorporated experts’ prior knowledge in the statistical analysis. Systematic reviews on elicitation literature however suggest that it might be inappropriate to directly obtain distributional representations from experts. The literature qualifies experts’ performance on estimating elements of a distribution as unsatisfactory, thus reliably specifying the essential elements of the parameters of interest in one elicitation step seems implausible. Providing feedback within the elicitation process can enhance the quality of the elicitation and interactive software can be used to facilitate the feedback. Therefore, we propose to decompose the elicitation procedure into smaller steps with adjustable outcomes. We represent the tacit knowledge of experts as a location parameter and their uncertainty concerning this knowledge by a scale and shape parameter. Using a feedback procedure, experts can accept the representation of their beliefs or adjust their input. We propose a Five-Step Method which consists of (1) Eliciting the location parameter using the trial roulette method. (2) Provide feedback on the location parameter and ask for confirmation or adjustment. (3) Elicit the scale and shape parameter. (4) Provide feedback on the scale and shape parameter and ask for confirmation or adjustment. (5) Use the elicited and calibrated probability distribution in a statistical analysis and update it with data or to compute a prior-data conflict within a Bayesian framework. User feasibility and internal validity for the Five-Step Method are investigated using three elicitation studies.

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Useof Expert Knowledge Elicitation to Estimate Parameters in Health Economic Decision Models

Abstract: The use of EKE for parameter estimation is common in HEDMs, although there is room for improvement in the methods used.

Cited by 16 publications

References 15 publications

The Health Equity and Effectiveness of Policy Options to Reduce Dietary Salt Intake in England: Policy Forecast

The Health Equity and Effectiveness of Policy Options to Reduce Dietary Salt Intake in England: Policy Forecast

Direct costs of transfusion reactions – an expert judgement approach

Proposal for a Five-Step Method to Elicit Expert Judgment

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