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Estimating uncertainty ranges for costs by the bootstrap procedure combined with probabilistic sensitivity analysis

Estimating uncertainty ranges for costs by the bootstrap procedure combined with probabilistic sensitivity analysis
Estimating uncertainty ranges for costs by the bootstrap procedure combined with probabilistic sensitivity analysis
When an economic evaluation incorporates patient-level data, there are two types of uncertainty over the results: uncertainty due to variation in the sampled data, and uncertainty over the choice of modelling parameters and assumptions. Previously statistical methods have been used to estimate the extent of the former, and sensitivity analysis to estimate the extent of the latter. Ideally interval estimates for economic variables should reflect both types of uncertainty. This paper describes a method for combining bootstrapping with probabilistic sensitivity analysis to estimate a total 'uncertainty range' for incremental costs. The approach is illustrated using cost data from a randomized controlled trial of endoscopy for Helicobactor pylori negative young dyspeptic patients. The trial failed to demonstrate any clinical benefit from endoscopy, which was on average pound 395 more costly. The combined 95% uncertainty range for incremental costs (-pound 236 to pound 931) was wider than 95% intervals estimated by either probabilistic sensitivity analysis (pound 43 to pound 592) or the non-parametric bootstrap method (-pound 95 to pound 667) alone. The method can easily be extended to the calculation of uncertainty ranges for incremental cost-effectiveness ratios
bootstrapping, sensitivity analysis, economic evaluation, uncertainty, dyspepsia
1099-1050
323-333
Lord, J.
fd3b2bf0-9403-466a-8184-9303bdc80a9a
Asante, M.A.
9848ea06-8dba-41e7-98b4-40ca6491215c
Lord, J.
fd3b2bf0-9403-466a-8184-9303bdc80a9a
Asante, M.A.
9848ea06-8dba-41e7-98b4-40ca6491215c

Lord, J. and Asante, M.A. (1999) Estimating uncertainty ranges for costs by the bootstrap procedure combined with probabilistic sensitivity analysis. Health Economics, 8 (4), 323-333. (doi:10.1002/(SICI)1099-1050(199906)8:4<323::AID-HEC431>3.0.CO;2-0). (PMID:10398525)

Record type: Article

Abstract

When an economic evaluation incorporates patient-level data, there are two types of uncertainty over the results: uncertainty due to variation in the sampled data, and uncertainty over the choice of modelling parameters and assumptions. Previously statistical methods have been used to estimate the extent of the former, and sensitivity analysis to estimate the extent of the latter. Ideally interval estimates for economic variables should reflect both types of uncertainty. This paper describes a method for combining bootstrapping with probabilistic sensitivity analysis to estimate a total 'uncertainty range' for incremental costs. The approach is illustrated using cost data from a randomized controlled trial of endoscopy for Helicobactor pylori negative young dyspeptic patients. The trial failed to demonstrate any clinical benefit from endoscopy, which was on average pound 395 more costly. The combined 95% uncertainty range for incremental costs (-pound 236 to pound 931) was wider than 95% intervals estimated by either probabilistic sensitivity analysis (pound 43 to pound 592) or the non-parametric bootstrap method (-pound 95 to pound 667) alone. The method can easily be extended to the calculation of uncertainty ranges for incremental cost-effectiveness ratios

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More information

Accepted/In Press date: 5 January 1999
Published date: June 1999
Keywords: bootstrapping, sensitivity analysis, economic evaluation, uncertainty, dyspepsia
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 382181
URI: http://eprints.soton.ac.uk/id/eprint/382181
ISSN: 1099-1050
PURE UUID: eea7dacd-bd06-4670-a98b-1779194f4a40
ORCID for J. Lord: ORCID iD orcid.org/0000-0003-1086-1624

Catalogue record

Date deposited: 23 Oct 2015 11:01
Last modified: 17 Dec 2019 01:33

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