ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2019
"Time Traveling Is Just Too Dangerous" but Some Methods Are Worth Revisiting: The Advantages of Expected Loss Curves Over Cost-Effectiveness Acceptability Curves and Frontier.
Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Treatments for renal cell carcinoma: NICE Pilot Treatment Pathways Appraisal.Health technology assessment (Winchester, England) · 2026Pooled it
- Benefits of colorectal cancer screening using fecal immunochemical testing with varying positivity thresholds by age and sex.Journal of the National Cancer Institute · 2025Pooled it
- Methods for Communicating the Impact of Parameter Uncertainty in a Multiple-Strategies Cost-Effectiveness Comparison.Medical decision making : an international journal of the Society for Medical Decision Making · 2022Pooled it
- Cost-Effective Threshold Price for Alternative Infant and Neonatal Rotavirus Vaccines: A Dual-Country Evaluation.medRxiv : the preprint server for health sciences · 2026Article
- Public health impact of catch-up vaccination or additional booster doses with pre-erythrocytic malaria vaccine R21/Matrix-M: a modelling study.BMC medicine · 2026Article
- Cost-effectiveness of maternal vaccine and/or monoclonal antibody strategies against respiratory syncytial virus in Belgian infants.NPJ vaccines · 2026Article
- Cost-Effectiveness of Acceptable-Quality Deceased Donor Kidneys for Transplant in Older Candidates.JAMA network open · 2026Article
- The cost of non-drug interventions that improve function and reduce dementia-related behaviors.BMC geriatrics · 2025Article
- Article
- Evaluating the Role and Policy Implications of Using External Evidence in Survival Extrapolations: A Case Study of Axicabtagene Ciloleucel Therapy for Second-Line DLBCL.PharmacoEconomics · 2025Article
- Psilocybin-assisted therapy for treatment-resistant depression in the US: a model-based cost-effectiveness analysis.Translational psychiatry · 2025Article
- Cost and Cost-Effectiveness of Treating Human Epidermal Growth Factor Receptor 2-Low Metastatic Breast Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- Influential drivers of the cost-effectiveness of respiratory syncytial virus vaccination in European older adults: a multi-country analysis.BMC medicine · 2025Article
- Incremental Cost-Effectiveness Ratios (ICERs) and Revised Metformin Cost-Effectiveness Conclusions in the Diabetes Prevention Program/ Diabetes Prevention Program Outcomes Study.American journal of lifestyle medicine · 2025Article
- Net Monetary Benefit Lines Augmented with Value-of-Information Measures to Present the Results of Economic Evaluations under Uncertainty.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Article
- NICE's Pathways Pilot: Pursuing Good Decision Making in Difficult Circumstances.PharmacoEconomics - open · 2024Article
- A Guide to an Iterative Approach to Model-Based Decision Making in Health and Medicine: An Iterative Decision-Making Framework.PharmacoEconomics · 2024Article
- Modeling the impact of a long-term horizon and multiple treatment episodes on estimates of the cost-effectiveness of alcohol treatment in the United States.Alcohol, clinical & experimental research · 2023Article
- Response to "UNCERTAINTY MANAGEMENT IN REGULATORY AND HEALTH TECHNOLOGY ASSESSMENT DECISION-MAKING ON DRUGS: GUIDANCE OF THE HTAi-DIA WORKING GROUP".International journal of technology assessment in health care · 2023Article
- Comprehensive Review of Methods to Assess Uncertainty in Health Economic Evaluations.PharmacoEconomics · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundCost-effectiveness acceptability curves (CEACs) and the cost-effectiveness acceptability frontier (CEAF) are the recommended graphical representations of uncertainty in a cost-effectiveness analysis (CEA). Nevertheless, many limitations of CEACs and the CEAF have been recognized by others. Expected loss curves (ELCs) overcome these limitations by displaying the expected foregone benefits of choosing one strategy over others, the optimal strategy in expectation, and the value of potential future research all in a single figure.
objectivesTo revisit ELCs, illustrate their benefits using a case study, and promote their adoption by providing open-source code.
methodsWe used a probabilistic sensitivity analysis of a CEA comparing 6 cerebrospinal fluid biomarker test-and-treat strategies in patients with mild cognitive impairment. We showed how to calculate ELCs for a set of decision alternatives. We used the probabilistic sensitivity analysis of the case study to illustrate the limitations of currently recommended methods for communicating uncertainty and then demonstrated how ELCs can address these issues.
resultsELCs combine the probability that each strategy is not cost-effective on the basis of current information and the expected foregone benefits resulting from choosing that strategy (ie, how much is lost if we recommended a strategy with a higher expected loss). ELCs display how the optimal strategy switches across willingness-to-pay thresholds and enables comparison between different strategies in terms of the expected loss.
conclusionsELCs provide a more comprehensive representation of uncertainty and overcome current limitations of CEACs and the CEAF. Communication of uncertainty in CEA would benefit from greater adoption of ELCs as a complementary method to CEACs, the CEAF, and the expected value of perfect information.
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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.