EconPapers    
Economics at your fingertips  
 

Life Expectancy Biases in Clinical Decision Modeling

Karen M. Kuntz and Milton C. Weinstein

Medical Decision Making, 1995, vol. 15, issue 2, 158-169

Abstract: Clinical decision models often rely upon survival models predicated on disease-specific hazard functions combined with baseline hazard functions obtained from standard life tables. Two biases may arise in such a modeling process. First, life expectancy estimates may be biased even if estimates of survival probabilities are unbiased (misestimation bias). In sim ulation studies, the authors discovered that the magnitude of misestimation bias is larger as life expectancy increases, sample size decreases, and censoring percentage increases. In the context of a simple decision analysis, they found that imbalances in the sample sizes for the data used to estimate the parameters among different strategies resulted in non- optimal decisions in the long run. The second bias stems from misspecification of the survival model itself (misspecification bias). Using a simple cost-effectiveness model, the authors found that life expectancies and incremental cost-effectiveness ratios differed depending on whether an excess-mortality or a proportional-hazards model was specified. In addition, a predictable pattern was observed for these two survival models when extrapolated to other age and gender groups. Key words: Markov models; Markov-cycle tree; decision making; excess-mortality model; proportional-hazards model; life expectancy. (Med Decis Making 1995;15:158-169)

Date: 1995
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X9501500209 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:15:y:1995:i:2:p:158-169

DOI: 10.1177/0272989X9501500209

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().

 
Page updated 2025-03-19
Handle: RePEc:sae:medema:v:15:y:1995:i:2:p:158-169