ArticleMedical decision making : an international journal of the Society for Medical Decision Making2014
The value of heterogeneity for cost-effectiveness subgroup analysis: conceptual framework and application.
Article in Medical decision making : an international journal of the Society for Medical Decision Making, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it, 94 citations in OpenAlex.
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- Generating evidence to inform health technology assessment of treatments for SLE: a systematic review of decision-analytic model-based economic evaluations.Lupus science & medicine · 2020Pooled it
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- Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Trial
- Cost-effectiveness of a national exercise referral programme for primary care patients in Wales: results of a randomised controlled trial.BMC public health · 2013Trial
- Individualized Treatment Rules Based on Cost-Effectiveness Criteria in Microsimulations.PharmacoEconomics · 2026Article
- Comparing the Influence of Heterogeneity on Model Outcomes in Individual-Level and Cohort Simulations: An Exploratory Simulation Study.PharmacoEconomics · 2026Article
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- Socioeconomic differences in the cost-effectiveness of a telephone-based intervention for obesity prevention in early childhood.International journal of obesity (2005) · 2026Article
- A Review of Heterogeneity in Comparative Economic Analysis, with Specific Considerations for the Decentralized US Setting and Patient-Centered Care.PharmacoEconomics · 2025Review
- Using Genomic Heterogeneity to Inform Therapeutic Decisions for Metastatic Colorectal Cancer: An Application of the Value of Heterogeneity Framework.Applied health economics and health policy · 2025Article
- Are Nutritional Interventions Worthwhile in Cancer Patients? A Systematic Review on Economic Evaluation.ClinicoEconomics and outcomes research : CEOR · 2025Review
- Machine Learning Methods to Estimate Individualized Treatment Effects for Use in Health Technology Assessment.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Review
- Challenges for gene therapy in the financial sustainability of health systems: a scoping review.Orphanet journal of rare diseases · 2024Article
- A Guide to an Iterative Approach to Model-Based Decision Making in Health and Medicine: An Iterative Decision-Making Framework.PharmacoEconomics · 2024Article
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- Review
- Is the cost-effectiveness of an early-childhood sleep intervention to prevent obesity affected by socioeconomic position?Obesity (Silver Spring, Md.) · 2023Article
- Local Instrumental Variable Methods to Address Confounding and Heterogeneity when Using Electronic Health Records: An Application to Emergency Surgery.Medical decision making : an international journal of the Society for Medical Decision Making · 2022Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
This article develops a general framework to guide the use of subgroup cost-effectiveness analysis for decision making in a collectively funded health system. In doing so, it addresses 2 key policy questions, namely, the identification and selection of subgroups, while distinguishing 2 sources of potential value associated with heterogeneity. These are 1) the value of revealing the factors associated with heterogeneity in costs and outcomes using existing evidence (static value) and 2) the value of acquiring further subgroup-related evidence to resolve the uncertainty given the current understanding of heterogeneity (dynamic value). Consideration of these 2 sources of value can guide subgroup-specific treatment decisions and inform whether further research should be conducted to resolve uncertainty to explain variability in costs and outcomes. We apply the proposed methods to a cost-effectiveness analysis for the management of patients with acute coronary syndrome. This study presents the expected net benefits under current and perfect information when subgroups are defined based on the use and combination of 6 binary covariates. The results of the case study confirm the theoretical expectations. As more subgroups are considered, the marginal net benefit gains obtained under the current information show diminishing marginal returns, and the expected value of perfect information shows a decreasing trend. We present a suggested algorithm that synthesizes the results to guide policy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.