A Bayesian approach to net health benefits: an illustration and application to modeling HIV prevention. Med Decis Making 2004;24(6):634-53
Date
11/10/2004Pubmed ID
15534344DOI
10.1177/0272989X04271040Scopus ID
2-s2.0-8744303778 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
PURPOSE: To conduct a cost-effectiveness analysis of HIV prevention when costs and effects cannot be measured directly. To quantify the total estimation of uncertainty due to sampling variability as well as inexact knowledge of HIV transmission parameters.
METHODS: The authors focus on estimating the incremental net health benefit (INHB) in a randomized trial of HIV prevention with intervention and control conditions. Using a Bernoulli model of HIV transmission, changes in the participants' risk behaviors are converted into the number of HIV infections averted. A sampling model is used to account for variation in the behavior measurements. Bayes's theorem and Monte Carlo methods are used to attain the stated objectives.
RESULTS: The authors obtained a positive mean INHB of 0.0008, indicating that advocacy training is just slightly favored over the control condition for men, assuming a $50,000 per quality-adjusted life year (QALY) threshold. To be confident of a positive INHB, the decision maker would need to spend more than $100,000 per QALY.
Author List
Johnson-Masotti AP, Laud PW, Hoffmann RG, Hayat MJ, Pinkerton SDAuthor
Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Bayes TheoremCost-Benefit Analysis
Decision Support Techniques
Female
HIV Infections
Humans
Male
Monte Carlo Method
Patient Education as Topic
Quality-Adjusted Life Years
Randomized Controlled Trials as Topic
Risk-Taking
Uncertainty