ArticleMedical decision making : an international journal of the Society for Medical Decision Making2020
Health Opportunity Costs: Assessing the Implications of Uncertainty Using Elicitation Methods with Experts.
Article in Medical decision making : an international journal of the Society for Medical Decision Making, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis 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
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementation costs of hospital-based computerised decision support systems: a systematic review.Implementation science : IS · 2023Pooled it
- Health costs of the UK-US trade deal on pharmaceuticals.BMJ (Clinical research ed.) · 2026Article
- Evaluating the Cost Effectiveness of Rapid Diagnostic Testing for the Identification of Pathogens and Resistance Genes in Bloodstream Infections.PharmacoEconomics · 2026Article
- Co-designing a Structured Expert Elicitation with Clinicians to Enhance Health Care Decision Making in Exercise Oncology.Medical decision making : an international journal of the Society for Medical Decision Making · 2025Article
- Healthcare Resource Utilization and Associated Costs During the First 5 Years After Diagnosis and at the End of Life: A Nationwide Cohort Study of Patients with Multiple Myeloma in Finland.PharmacoEconomics - open · 2025Article
- Examining uncertainty in journal peer reviewers' recommendations: a cross-sectional study.Royal Society open science · 2024Article
- Is Time Spent on Prior Authorizations Associated With Approval?The journal for nurse practitioners : JNP · 2023Article
- Supply-Side Cost-Effectiveness Thresholds: Questions for Evidence-Based Policy.Applied health economics and health policy · 2022Review
- The cost-per-QALY threshold in England: Identifying structural uncertainty in the estimates.Frontiers in health services · 2022Article
- How Effective is Marginal Healthcare Expenditure? New Evidence from England for 2003/04 to 2012/13.Applied health economics and health policy · 2021Article
- Developing a reference protocol for structured expert elicitation in health-care decision-making: a mixed-methods study.Health technology assessment (Winchester, England) · 2021Review
- Authors' Response to: "Health Opportunity Costs and Expert Elicitation: A Comment on Soares et al." by Sampson, Firth, and Towse.Medical decision making : an international journal of the Society for Medical Decision Making · 2021Article
- Informing a Cost-Effectiveness Threshold for Health Technology Assessment in China: A Marginal Productivity Approach.PharmacoEconomics · 2020Article
- An Economic Evaluation Framework for Government-Funded Home Adaptation Schemes: A Quantitative Approach.Healthcare (Basel, Switzerland) · 2020Article
- How Useful Are Early Economic Models? Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modelling".International journal of health policy and management · 2020Article
- Estimating Social Variation in the Health Effects of Changes in Health Care Expenditure.Medical decision making : an international journal of the Society for Medical Decision Making · 2020Article
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Abstract
Well-established methods of economic evaluation are used in many countries to inform decisions about the funding of new medical interventions. To guide such decisions, it is important to consider what health gains would be expected from the same level of investment elsewhere in the health care system. Recent research in the United Kingdom has evaluated the evidence available and the methods required to estimate the health effects of changes in health care expenditure within the National Health Service. Because of the absence of sufficiently broad-ranging data, assumptions were required in the previously mentioned work to estimate health effects in terms of a broader measure of health (quality-adjusted life-years), which is more relevant for policy. These assumptions constitute important sources of uncertainty. This work presents an application of the structured elicitation of the judgments of key individuals about these uncertain quantities. This article describes the design and conduct of the exercise, including the quantities elicited, the individual (rather than consensus) approach used, how uncertainty in knowledge was elicited (mode and bounds of an 80% credible interval), and methods to generate group estimates. It also reports on a successful application involving 28 clinical experts and 25 individuals with policy responsibilities. Although, as expected, most experts found replying to the questions challenging, they were able to express their beliefs quantitatively. Consistent across the uncertainties elicited, experts' judgments suggest that the quality-adjusted life-year (QALY) impacts of changes in expenditure from earlier work using assumptions are likely to have been underestimated and the "central" estimate of health opportunity cost from that work (£12,936 per QALY) to have been overestimated.
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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.