IDEAS home Printed from
   My bibliography  Save this article

Structural and parameter uncertainty in Bayesian cost-effectiveness models


  • Christopher H. Jackson
  • Linda D. Sharples
  • Simon G. Thompson


Health economic decision models are subject to various forms of uncertainty, including uncertainty about the parameters of the model and about the model structure. These uncertainties can be handled within a Bayesian framework, which also allows evidence from previous studies to be combined with the data. As an example, we consider a Markov model for assessing the cost-effectiveness of implantable cardioverter defibrillators. Using Markov chain Monte Carlo posterior simulation, uncertainty about the parameters of the model is formally incorporated in the estimates of expected cost and effectiveness. We extend these methods to include uncertainty about the choice between plausible model structures. This is accounted for by averaging the posterior distributions from the competing models using weights that are derived from the pseudo-marginal-likelihood and the deviance information criterion, which are measures of expected predictive utility. We also show how these cost-effectiveness calculations can be performed efficiently in the widely used software WinBUGS. Copyright Journal compilation (c) 2010 Royal Statistical Society.

Suggested Citation

  • Christopher H. Jackson & Linda D. Sharples & Simon G. Thompson, 2010. "Structural and parameter uncertainty in Bayesian cost-effectiveness models," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 59(2), pages 233-253.
  • Handle: RePEc:bla:jorssc:v:59:y:2010:i:2:p:233-253

    Download full text from publisher

    File URL:
    File Function: link to full text
    Download Restriction: Access to full text is restricted to subscribers.

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629, June.
    2. Jackson, Christopher H, 2008. "Displaying Uncertainty With Shading," The American Statistician, American Statistical Association, vol. 62(4), pages 340-347.
    3. Christopher H. Jackson & Simon G. Thompson & Linda D. Sharples, 2009. "Accounting for uncertainty in health economic decision models by using model averaging," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 172(2), pages 383-404.
    4. Rebecca M. Turner & David J. Spiegelhalter & Gordon C. S. Smith & Simon G. Thompson, 2009. "Bias modelling in evidence synthesis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 172(1), pages 21-47.
    5. David J. Spiegelhalter & Nicola G. Best & Bradley P. Carlin & Angelika van der Linde, 2002. "Bayesian measures of model complexity and fit," Journal of the Royal Statistical Society Series B, Royal Statistical Society, vol. 64(4), pages 583-639.
    6. Nicola J. Cooper & Alex J. Sutton & Keith R. Abrams & David Turner & Allan Wailoo, 2004. "Comprehensive decision analytical modelling in economic evaluation: a Bayesian approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 203-226.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Jackson Christopher H & Sharples Linda D & Thompson Simon G, 2010. "Survival Models in Health Economic Evaluations: Balancing Fit and Parsimony to Improve Prediction," The International Journal of Biostatistics, De Gruyter, vol. 6(1), pages 1-31, October.

    More about this item


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:jorssc:v:59:y:2010:i:2:p:233-253. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wiley-Blackwell Digital Licensing) or (Christopher F. Baum). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.