Cost-effectiveness Analysis in R Using a Multi-state Modeling Survival Analysis Framework: A Tutorial
Claire Williams,
James D. Lewsey,
Andrew H. Briggs and
Daniel F. Mackay
Medical Decision Making, 2017, vol. 37, issue 4, 340-352
Abstract:
This tutorial provides a step-by-step guide to performing cost-effectiveness analysis using a multi-state modeling approach. Alongside the tutorial, we provide easy-to-use functions in the statistics package R . We argue that this multi-state modeling approach using a package such as R has advantages over approaches where models are built in a spreadsheet package. In particular, using a syntax-based approach means there is a written record of what was done and the calculations are transparent. Reproducing the analysis is straightforward as the syntax just needs to be run again. The approach can be thought of as an alternative way to build a Markov decision-analytic model, which also has the option to use a state-arrival extended approach. In the state-arrival extended multi-state model, a covariate that represents patients’ history is included, allowing the Markov property to be tested. We illustrate the building of multi-state survival models, making predictions from the models and assessing fits. We then proceed to perform a cost-effectiveness analysis, including deterministic and probabilistic sensitivity analyses. Finally, we show how to create 2 common methods of visualizing the results—namely, cost-effectiveness planes and cost-effectiveness acceptability curves. The analysis is implemented entirely within R . It is based on adaptions to functions in the existing R package mstate to accommodate parametric multi-state modeling that facilitates extrapolation of survival curves.
Keywords: Markov models; cost-effectiveness analysis; probabilistic sensitivity analysis; survival analysis (search for similar items in EconPapers)
Date: 2017
References: View references in EconPapers View complete reference list from CitEc
Citations:
Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X16651869 (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:37:y:2017:i:4:p:340-352
DOI: 10.1177/0272989X16651869
Access Statistics for this article
More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().