Multiparameter evidence synthesis in epidemiology and medical decision-making: current approaches

被引:109
作者
Ades, AE
Sutton, AJ
机构
[1] Univ Bristol, MRC, Hlth Serv Res Collaborat, Bristol BS8 2PR, Avon, England
[2] Univ Leicester, Leicester LE1 7RH, Leics, England
关键词
Bayesian methods; decision-making; evidence synthesis; hierarchical models;
D O I
10.1111/j.1467-985X.2005.00377.x
中图分类号
O1 [数学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 0701 ; 070101 ;
摘要
Alongside the development of meta-analysis as a tool for summarizing research literature, there is renewed interest in broader forms of quantitative synthesis that are aimed at combining evidence from different study designs or evidence on multiple parameters. These have been proposed under various headings: the confidence profile method, cross-design synthesis, hierarchical models and generalized evidence synthesis. Models that are used in health technology assessment are also referred to as representing a synthesis of evidence in a mathematical structure. Here we review alternative approaches to statistical evidence synthesis, and their implications for epidemiology and medical decision-making. The methods include hierarchical models, models informed by evidence on different functions of several parameters and models incorporating both of these features. The need to check for consistency of evidence when using these powerful methods is emphasized. We develop a rationale for evidence synthesis that is based on Bayesian decision modelling and expected value of information theory, which stresses not only the need for a lack of bias in estimates of treatment effects but also a lack of bias in assessments of uncertainty. The increasing reliance of governmental bodies like the UK National Institute for Clinical Excellence on complex evidence synthesis in decision modelling is discussed.
引用
收藏
页码:5 / 35
页数:31
相关论文
共 121 条
[1]  
ABRAMS KR, 2003, DEV EC EV METH 4 WRK
[2]   Expected value of sample information calculations in medical decision modeling [J].
Ades, AE ;
Lu, G ;
Claxton, K .
MEDICAL DECISION MAKING, 2004, 24 (02) :207-227
[3]   Correlations between parameters in risk models: Estimation and propagation of uncertainty by Markov Chain Monte Carlo [J].
Ades, AE ;
Lu, G .
RISK ANALYSIS, 2003, 23 (06) :1165-1172
[4]   A chain of evidence with mixed comparisons: models for multi-parameter synthesis and consistency of evidence [J].
Ades, AE .
STATISTICS IN MEDICINE, 2003, 22 (19) :2995-3016
[5]   Markov chain Monte Carlo estimation of a multiparameter decision model: Consistency of evidence and the accurate assessment of uncertainty [J].
Ades, AE ;
Cliffe, S .
MEDICAL DECISION MAKING, 2002, 22 (04) :359-371
[6]  
[Anonymous], 1992, LANCET, V340, P944
[7]  
[Anonymous], 2002, MODELING MED DECISIO
[8]  
[Anonymous], 2000, METANALYSIS DECISION
[9]  
[Anonymous], 1995, Systematic reviews
[10]  
[Anonymous], 1996, BAYESIAN STAT