Health Economics and Health Technology Assessment (HEHTA)

Decision Analytic Modelling and simulation for Evaluation in Health (DAMSEL)

Programme lead: Elisabeth Fenwick

The DAMSEL Programme encompasses research work associated with conducting an evaluation using modelling or simulation methods. The following are examples of ongoing studies or recently completed projects involving DAMSEL:

Infertility Services Waiting Time Model

This discrete event simulation models the operational characteristics of IVF services in Scotland with the aim of predicting the possible impacts on waiting times of various changes to the delivery of these services. 

HEHTA contact: Elisabeth Fenwick

Estimating Cost Effectiveness for Screening Strategies for Hepatitis B, C and HIV Infection in different populations in Europe

Funded by European Centre for Disease Prevention and Control, this study involves the development of a model and toolkit to be used across Europe to assess the impact and cost-effectiveness of screening interventions for Hep B, Hep C and HIV infection.

HEHTA contact: Olivia Wu, Elisabeth Fenwick

Football Fans in Training (FFIT) ): a randomized controlled trial of a gender-sensitive weight loss and healthy living programme delivered to men aged 35-65 by Scottish Premier League football clubs. 

Funded by the NIHR Public Health Research Programme this study will assess the effectiveness and cost-effectiveness of a group-based, weight loss and healthy living programme, specifically designed to engage men who are often reluctant to join existing weight loss programmes. In addition to a within trial economic evaluation of FFIT, a model will be developed to link short term outcomes from the RCT to potential longer term impacts on health.

HEHTA contact: Eleanor Grieve

Transcatheter Aortic Valve Implantation – access with evidence development case study

This project developed from a workshop in “coverage with evidence development” held in Glasgow in 2008. A conceptual model was constructed to assess the costs, effectiveness and cost-effectiveness of TAVI in comparison to the alternatives for 3 risk sub-groups. The initial analysis was based on the limited data available within the literature. Subsequently, the model has been updated and re-analysed as evidence about the use of TAVI has accrued. 

HEHTA contact: Elisabeth Fenwick or Aileen Murphy

Universal health checks – pre-study modelling

This decision model was constructed to assess the potential impact (in terms of CVD events avoided), costs and expected cost-effectiveness of a universal screening programme for CVD compared with the established targeted screening programme. In addition, results from the model were used to estimate the sample size that would be required for a pilot trial of the programme and the expected cost of such a trial.

 HEHTA contact: Eleanor Grieve

The value of FDG positron emission tomography/ computerised tomography (PET/CT) in pre-operative staging of colorectal cancer: a systematic review and economic evaluation 

Funded by the NIHR HTA programme this project assessed the use of PET/CT compared to standard strategies for pre-operative staging of colorectal cancer. Models were constructed to represent the patient pathways and different diagnostic approaches associated with primary colon cancer, primary rectal cancer, recurrent colon cancer, recurrent rectal cancer and metastatic colorectal cancer. Results from each of the models identified the likely impact of PET/CT in terms of diagnostic accuracy, patient management, morbidity, mortality and cost-effectiveness. In addition, a value of information analysis identified areas where future research may be potentially worthwhile. Further details and a copy of the report are available here.

HEHTA contact: Kathleen Boyd
 

A pre-trial model of coronary guidewire assisted cardiography for NSTEMI patients

Funded by the CSO, this project was to develop an early cost-effectiveness model to assist in the design of a subsequent trial.  The measurement of fractional flow reserve (FFR) using a coronary guidewire with a pressure sensor has the potential to improve the diagnostic accuracy of coronary artery disease (CAD) and is now an established technique in the invasive management of people with stable CAD.  The question this model seeks to address is whether this technique might also have benefits or non-ST-elevated myocardial infarction (NSTEMI) patients and what would be the most efficient trial design to establish the effectiveness and cost-effectiveness of FFR in this patient group.

HEHTA contact: Andrew Briggs

In addition to funded evaluations using models, the programme also covers more methodological work.  Members of the programme were involved in the recent ISPOR-SMDM Modeling Good Research Practices Task Force. Recommendations are available online from both ISPOR and SMDM.
HEHTA also collaborates with colleagues at Centre for Health Economics, University of York to host continuing professional development courses on “Decision analytic modelling for economic evaluation” and “Advanced Modelling Methods Course for Health Economic Evaluation