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Evidence Synthesis and Linkage for Modelling the Cost-Effectiveness of Diagnostic Tests: Preliminary Good Practice Recommendations

Author

Listed:
  • Bethany Shinkins

    (University of Warwick
    University of Leeds
    NIHR Leeds In Vitro Diagnostics Co-operative (MIC))

  • A. Joy Allen

    (Roche Diagnostics UK and Ireland)

  • James Karichu

    (Roche Diagnostics Solutions)

  • Louis P. Garrison

    (University of Washington)

  • Brigitta U. Monz

    (Roche Diagnostics International AG)

Abstract

Objectives To develop preliminary good practice recommendations for synthesising and linking evidence of treatment effectiveness when modelling the cost-effectiveness of diagnostic tests. Methods We conducted a targeted review of guidance from key Health Technology Assessment (HTA) bodies to summarise current recommendations on synthesis and linkage of treatment effectiveness evidence within economic evaluations of diagnostic tests. We then focused on a specific case study, the cost-effectiveness of troponin for the diagnosis of myocardial infarction, and reviewed the approach taken to synthesise and link treatment effectiveness evidence in different modelling studies. Results The Australian and UK HTA bodies provided advice for synthesising and linking treatment effectiveness in diagnostic models, acknowledging that linking test results to treatment options and their outcomes is common. Across all reviewed models for the case study, uniform test-directed treatment decision making was assumed, i.e., all those who tested positive were treated. Treatment outcome data from a variety of sources, including expert opinion, were utilised for linked clinical outcomes. Preliminary good practice recommendations for data identification, integration and description are proposed. Conclusion Modelling the cost-effectiveness of diagnostic tests poses unique challenges in linking evidence on test accuracy to treatment effectiveness data to understand how a test impacts patient outcomes and costs. Upfront consideration of how a test and its results will likely be incorporated into patient diagnostic pathways is key to exploring the optimal design of such models. We propose some preliminary good practice recommendations to improve the quality of cost-effectiveness evaluations of diagnostics tests going forward.

Suggested Citation

  • Bethany Shinkins & A. Joy Allen & James Karichu & Louis P. Garrison & Brigitta U. Monz, 2024. "Evidence Synthesis and Linkage for Modelling the Cost-Effectiveness of Diagnostic Tests: Preliminary Good Practice Recommendations," Applied Health Economics and Health Policy, Springer, vol. 22(2), pages 131-144, March.
    • Handle: RePEc:spr:aphecp:v:22:y:2024:i:2:d:10.1007_s40258-023-00855-z
    DOI: 10.1007/s40258-023-00855-z
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    1. Michelle M.A. Kip & Maarten J. IJzerman & Martin Henriksson & Tracy Merlin & Milton C. Weinstein & Charles E. Phelps & Ron Kusters & Hendrik Koffijberg, 2018. "Toward Alignment in the Reporting of Economic Evaluations of Diagnostic Tests and Biomarkers: The AGREEDT Checklist," Medical Decision Making, , vol. 38(7), pages 778-788, October.
    2. Paul Kind & Geoffrey Hardman & Susan Macran, 1999. "UK population norms for EQ-5D," Working Papers 172chedp, Centre for Health Economics, University of York.
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