A Tutorial on Time-Dependent Cohort State-Transition Models in R using a Cost-Effectiveness Analysis Example

Fernando Alarid-Escudero, Eline M. Krijkamp, Eva A. Enns, Alan Yang, M. G. Myriam Hunink, Petros Pechlivanoglou and Hawre Jalal

Papers from arXiv.org

Abstract: In an introductory tutorial, we illustrated building cohort state-transition models (cSTMs) in R, where the state transitions probabilities were constant over time. However, in practice, many cSTMs require transitions, rewards, or both to vary over time (time-dependent). This tutorial illustrates adding two types of time-dependency using a previously published cost-effectiveness analysis of multiple strategies as an example. The first is simulation-time dependence, which allows for the transition probabilities to vary as a function of time as measured since the start of the simulation (e.g., varying probability of death as the cohort ages). The second is state-residence time dependence, allowing for history by tracking the time spent in any particular health state using tunnel states. We use these time-dependent cSTMs to conduct cost-effectiveness and probabilistic sensitivity analyses. We also obtain various epidemiological outcomes of interest from the outputs generated from the cSTM, such as survival probability and disease prevalence, often used for model calibration and validation. We present the mathematical notation first, followed by the R code to execute the calculations. The full R code is provided in a public code repository for broader implementation.

Date: 2021-08, Revised 2022-06
New Economics Papers: this item is included in nep-hea and nep-isf
References: View references in EconPapers View complete reference list from CitEc
Citations:

Published in Medical Decision Making, 2022

Downloads: (external link)
http://arxiv.org/pdf/2108.13552 Latest version (application/pdf)

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:arx:papers:2108.13552

Access Statistics for this paper

More papers in Papers from arXiv.org
Bibliographic data for series maintained by arXiv administrators ().