A framework for quantifying uncertainty about costs, effectiveness measures, and marginal cost-effectiveness ratios in complex decision models is presented. This type of application requires special techniques because of the multiple sources of information and the model-based combination of data. The authors discuss two alternative approaches, one based on Bayesian inference and the other on re...

Incremental or marginal cost-effectiveness ratios are founded on a number of assumptions that weaken their suitability as a way to balance competing economic and clinical priorities. We therefore propose a more relevant and responsible way to gauge the impact of clinical management strategies based on “consumer protection” principles— explicit disclosure of (1) the total magnitude of expected b...

INTRODUCTION: Several studies carried out to establish the relative preference of cost-effectiveness of interventions and severity of disease as criteria for priority setting in health have shown a strong preference for severity of disease. These preferences may differ in contexts of resource scarcity, as in developing countries, yet information is limited on such preferences in this context. O...

Many clinicians believe that allowing costs to influence clinical decisions is unethical. They are mistaken in this belief, because it cannot be ethical to ignore the adverse consequences upon others of the decisions you make, which is what 'costs' represent. There are, however, some important ethical issues in deciding what costs to count, and how to count them. But these dilemmas are equally ...

Unfortunately, the original version of this article [1] contained an error. An entry was incorrect Uttley et al. in the reference list. The correct reference can be found below: Uttley L, Scope A, Stevenson M, Rawdin A, Taylor Buck E, Sutton A, et al. Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic ment...

OBJECTIVES To establish the credibility of manual reticulocyte counts without compromising the quality of care, and to evaluate the degree of acceptability of manual reticulocyte counts in terms of accuracy and cost effectiveness in comparison with two automated haematology analyzers. METHODS Visual reticulocyte enumeration was evaluated for comparability, within-batch precision and costing w...

This study was undertaken to audit staff varicella policy for UK paediatric centres, and to estimate the cost-effectiveness of implementing a staff varicella vaccine policy. A telephone survey of 22 hospitals was performed to determine the policy regarding varicella immune status among healthcare workers (HCWs). All hospitals surveyed except one recorded immune status of informed HCWs, and had ...

Four forms of psychoanalytically oriented psychotherapy involving experienced therapists and psychiatric outpatients were compared in an outcome investigation. Patients received either individual therapy or group therapy that lasted either 6 months or 24 months. A comprehensive set of outcome scores provided by patients, therapists, and an independent assessor was monitored each 6 months includ...

In recent years, cost-effectiveness data have strongly influenced clinical practice guidelines for several cardiovascular treatments. Economic considerations are increasingly common as health systems are under mounting pressure to maximise value for money. The quality-adjusted life year (QALY)-an outcome measure that expresses the duration and quality of life-is the main pillar of cost-effectiv...

The past three decades have seen a rapid growth in the discipline of health economics, particularly in the area of economic evaluation of health care interventions. The aim of this article is to provide an introduction to the concepts of economic evaluation in health care, and the methodological issues pertaining to the identification, measurement and valuation of costs and benefits. In a subse...