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Structuring a conceptual model for cost-effectiveness analysis of frailty interventions

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  • Hossein Haji Ali Afzali
  • Jonathan Karnon
  • Olga Theou
  • Justin Beilby
  • Matteo Cesari
  • Renuka Visvanathan

Abstract

Background: Frailty is a major health issue which impacts the life of older people, posing a significant challenge to the health system. One of the key emerging areas is the development of frailty interventions to halt or reverse the progression of the condition. In many countries, economic evidence is required to inform public funding decisions for such interventions, and cost-effectiveness models are needed to estimate long-term costs and effects. Such models should capture current clinical understanding of frailty, its progression and its health consequences. The objective of this paper is to present a conceptual model of frailty that can be used to inform the development of a cost-effectiveness model to evaluate frailty interventions. Methods: After critical analysis of the clinical and economic literature, a Delphi study consisting of experts from the disciplines of clinical medicine and epidemiology was undertaken to inform the key components of the conceptual model. We also identified relevant databases that can be used to populate and validate the model. Results: A list of significant health states/events for which frailty is a strong independent risk factor was identified (e.g., hip fracture, hospital admission, delirium, death). We also identified a list of important patient attributes that may influence disease progression (e.g., age, gender, previous hospital admissions, depression). A number of large-scale relevant databases were also identified to populate and validate the cost-effectiveness model. Face validity of model structure was confirmed by experts. Discussion and conclusions: The proposed conceptual model is being used as a basis for developing a new cost-effectiveness model to estimate lifetime costs and outcomes associated with a range of frailty interventions. Using an appropriate model structure, which more accurately reflects the natural history of frailty, will improve model transparency and accuracy. This will ultimately lead to better informed public funding decisions around interventions to manage frailty.

Suggested Citation

  • Hossein Haji Ali Afzali & Jonathan Karnon & Olga Theou & Justin Beilby & Matteo Cesari & Renuka Visvanathan, 2019. "Structuring a conceptual model for cost-effectiveness analysis of frailty interventions," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-13, September.
    • Handle: RePEc:plo:pone00:0222049
    DOI: 10.1371/journal.pone.0222049
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    1. Mark Roberts & Louise B. Russell & A. David Paltiel & Michael Chambers & Phil McEwan & Murray Krahn, 2012. "Conceptualizing a Model," Medical Decision Making, , vol. 32(5), pages 678-689, September.
    2. Cynthia P. Iglesias & Alexander Thompson & Wolf H. Rogowski & Katherine Payne, 2016. "Reporting Guidelines for the Use of Expert Judgement in Model-Based Economic Evaluations," PharmacoEconomics, Springer, vol. 34(11), pages 1161-1172, November.
    3. David M. Eddy & William Hollingworth & J. Jaime Caro & Joel Tsevat & Kathryn M. McDonald & John B. Wong, 2012. "Model Transparency and Validation," Medical Decision Making, , vol. 32(5), pages 733-743, September.
    4. Hazel Squires & James Chilcott & Ronald Akehurst & Jennifer Burr & Michael P. Kelly, 2016. "A systematic literature review of the key challenges for developing the structure of public health economic models," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(3), pages 289-298, April.
    5. Christopher H. Jackson & Laura Bojke & Simon G. Thompson & Karl Claxton & Linda D. Sharples, 2011. "A Framework for Addressing Structural Uncertainty in Decision Models," Medical Decision Making, , vol. 31(4), pages 662-674, July.
    6. M. Brisson & W. J. Edmunds, 2006. "Impact of Model, Methodological, and Parameter Uncertainty in the Economic Analysis of Vaccination Programs," Medical Decision Making, , vol. 26(5), pages 434-446, September.
    7. Samantha Husbands & Susan Jowett & Pelham Barton & Joanna Coast, 2017. "How Qualitative Methods Can be Used to Inform Model Development," PharmacoEconomics, Springer, vol. 35(6), pages 607-612, June.
    8. Quang A. Le, 2016. "Structural Uncertainty of Markov Models for Advanced Breast Cancer," Medical Decision Making, , vol. 36(5), pages 629-640, July.
    9. Gerardus Frederix & Johan Hasselt & Jan Schellens & Anke Hövels & Jan Raaijmakers & Alwin Huitema & Johan Severens, 2014. "The Impact of Structural Uncertainty on Cost-Effectiveness Models for Adjuvant Endocrine Breast Cancer Treatments: the Need for Disease-Specific Model Standardization and Improved Guidance," PharmacoEconomics, Springer, vol. 32(1), pages 47-61, January.
    10. Hossein Haji Ali Afzali & Laura Bojke & Jonathan Karnon, 2018. "Model Structuring for Economic Evaluations of New Health Technologies," PharmacoEconomics, Springer, vol. 36(11), pages 1309-1319, November.
    11. Jonathan Karnon & Hossein Haji Ali Afzali & Gregorius Virgianto Arpuji Anggoro Putro & Phyu Win Thant & Ameline Dompok & Ingrid Cox & Owen Henry Chikhwaza & Xian Wang & Mercy Mukui Mwangangi & Matahar, 2017. "A Cost-Effectiveness Model for Frail Older Persons: Development and Application to a Physiotherapy-Based Intervention," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 635-645, October.
    12. Catherine Milte & Ruth Walker & Mary Luszcz & Emily Lancsar & Billingsley Kaambwa & Julie Ratcliffe, 2014. "How Important Is Health Status in Defining Quality of Life for Older People? An Exploratory Study of the Views of Older South Australians," Applied Health Economics and Health Policy, Springer, vol. 12(1), pages 73-84, February.
    13. Jacqueline J Suijker & Janet L MacNeil-Vroomen & Marjon van Rijn & Bianca M Buurman & Sophia E de Rooij & Eric P Moll van Charante & Judith E Bosmans, 2017. "Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people: Results of a cluster randomized trial," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-16, April.
    14. Maggie Tabberer & Sebastian Gonzalez-McQuire & Hana Muellerova & Andrew H. Briggs & Maureen P. M. H. Rutten-van Mölken & Mike Chambers & David A. Lomas, 2017. "Development of a Conceptual Model of Disease Progression for Use in Economic Modeling of Chronic Obstructive Pulmonary Disease," Medical Decision Making, , vol. 37(4), pages 440-452, May.
    15. Hossein Haji Ali Afzali & Jonathan Karnon & Tracy Merlin, 2013. "Improving the Accuracy and Comparability of Model-Based Economic Evaluations of Health Technologies for Reimbursement Decisions," Medical Decision Making, , vol. 33(3), pages 325-332, April.
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