Structuring and validating a cost-effectiveness model of primary asthma prevention amongst children

<p>Abstract</p> <p>Background</p> <p>Given the rising number of asthma cases and the increasing costs of health care, prevention may be the best cure. Decisions regarding the implementation of prevention programmes in general and choosing between unifaceted and multifac...

Full description

Bibliographic Details
Main Authors: Ramos G Feljandro P, Kuiper Sandra, Dompeling Edward, van Asselt Antoinette DI, de Grauw Wim JC, Knottnerus J, van Schayck Onno CP, Schermer Tjard RJ, Severens Johan L
Format: Article
Language:English
Published: BMC 2011-11-01
Series:BMC Medical Research Methodology
Online Access:http://www.biomedcentral.com/1471-2288/11/150
_version_ 1818520492660752384
author Ramos G Feljandro P
Kuiper Sandra
Dompeling Edward
van Asselt Antoinette DI
de Grauw Wim JC
Knottnerus J
van Schayck Onno CP
Schermer Tjard RJ
Severens Johan L
author_facet Ramos G Feljandro P
Kuiper Sandra
Dompeling Edward
van Asselt Antoinette DI
de Grauw Wim JC
Knottnerus J
van Schayck Onno CP
Schermer Tjard RJ
Severens Johan L
author_sort Ramos G Feljandro P
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Given the rising number of asthma cases and the increasing costs of health care, prevention may be the best cure. Decisions regarding the implementation of prevention programmes in general and choosing between unifaceted and multifaceted strategies in particular are urgently needed. Existing trials on the primary prevention of asthma are, however, insufficient on their own to inform the decision of stakeholders regarding the cost-effectiveness of such prevention strategies. Decision analytic modelling synthesises available data for the cost-effectiveness evaluation of strategies in an explicit manner. Published reports on model development should provide the detail and transparency required to increase the acceptability of cost-effectiveness modelling. But, detail on the explicit steps and the involvement of experts in structuring a model is often unevenly reported. In this paper, we describe a procedure to structure and validate a model for the primary prevention of asthma in children.</p> <p>Methods</p> <p>An expert panel was convened for round-table discussions to frame the cost-effectiveness research question and to select and structure a model. The model's structural validity, which indicates how well a model reflects the reality, was determined through descriptive and parallel validation. Descriptive validation was performed with the experts. Parallel validation qualitatively compared similarity between other published models with different decision problems.</p> <p>Results</p> <p>The multidisciplinary input of experts helped to develop a decision-tree structure which compares the current situation with screening and prevention. The prevention was further divided between multifaceted and unifaceted approaches to analyse the differences. The clinical outcome was diagnosis of asthma. No similar model was found in the literature discussing the same decision problem. Structural validity in terms of descriptive validity was achieved with the experts and was supported by parallel validation.</p> <p>Conclusions</p> <p>A decision-tree model developed with experts in round-table discussions benefits from a systematic and transparent approach and the multidisciplinary contributions of the experts. Parallel validation provides a feasible alternative to validating novel models. The process of structuring and validating a model presented in this paper could be a useful guide to increase transparency, credibility, and acceptability of (future, novel) models when experts are involved.</p>
first_indexed 2024-12-11T01:38:15Z
format Article
id doaj.art-e2722ca1e5fa4590bddac24100404ce1
institution Directory Open Access Journal
issn 1471-2288
language English
last_indexed 2024-12-11T01:38:15Z
publishDate 2011-11-01
publisher BMC
record_format Article
series BMC Medical Research Methodology
spelling doaj.art-e2722ca1e5fa4590bddac24100404ce12022-12-22T01:25:08ZengBMCBMC Medical Research Methodology1471-22882011-11-0111115010.1186/1471-2288-11-150Structuring and validating a cost-effectiveness model of primary asthma prevention amongst childrenRamos G Feljandro PKuiper SandraDompeling Edwardvan Asselt Antoinette DIde Grauw Wim JCKnottnerus Jvan Schayck Onno CPSchermer Tjard RJSeverens Johan L<p>Abstract</p> <p>Background</p> <p>Given the rising number of asthma cases and the increasing costs of health care, prevention may be the best cure. Decisions regarding the implementation of prevention programmes in general and choosing between unifaceted and multifaceted strategies in particular are urgently needed. Existing trials on the primary prevention of asthma are, however, insufficient on their own to inform the decision of stakeholders regarding the cost-effectiveness of such prevention strategies. Decision analytic modelling synthesises available data for the cost-effectiveness evaluation of strategies in an explicit manner. Published reports on model development should provide the detail and transparency required to increase the acceptability of cost-effectiveness modelling. But, detail on the explicit steps and the involvement of experts in structuring a model is often unevenly reported. In this paper, we describe a procedure to structure and validate a model for the primary prevention of asthma in children.</p> <p>Methods</p> <p>An expert panel was convened for round-table discussions to frame the cost-effectiveness research question and to select and structure a model. The model's structural validity, which indicates how well a model reflects the reality, was determined through descriptive and parallel validation. Descriptive validation was performed with the experts. Parallel validation qualitatively compared similarity between other published models with different decision problems.</p> <p>Results</p> <p>The multidisciplinary input of experts helped to develop a decision-tree structure which compares the current situation with screening and prevention. The prevention was further divided between multifaceted and unifaceted approaches to analyse the differences. The clinical outcome was diagnosis of asthma. No similar model was found in the literature discussing the same decision problem. Structural validity in terms of descriptive validity was achieved with the experts and was supported by parallel validation.</p> <p>Conclusions</p> <p>A decision-tree model developed with experts in round-table discussions benefits from a systematic and transparent approach and the multidisciplinary contributions of the experts. Parallel validation provides a feasible alternative to validating novel models. The process of structuring and validating a model presented in this paper could be a useful guide to increase transparency, credibility, and acceptability of (future, novel) models when experts are involved.</p>http://www.biomedcentral.com/1471-2288/11/150
spellingShingle Ramos G Feljandro P
Kuiper Sandra
Dompeling Edward
van Asselt Antoinette DI
de Grauw Wim JC
Knottnerus J
van Schayck Onno CP
Schermer Tjard RJ
Severens Johan L
Structuring and validating a cost-effectiveness model of primary asthma prevention amongst children
BMC Medical Research Methodology
title Structuring and validating a cost-effectiveness model of primary asthma prevention amongst children
title_full Structuring and validating a cost-effectiveness model of primary asthma prevention amongst children
title_fullStr Structuring and validating a cost-effectiveness model of primary asthma prevention amongst children
title_full_unstemmed Structuring and validating a cost-effectiveness model of primary asthma prevention amongst children
title_short Structuring and validating a cost-effectiveness model of primary asthma prevention amongst children
title_sort structuring and validating a cost effectiveness model of primary asthma prevention amongst children
url http://www.biomedcentral.com/1471-2288/11/150
work_keys_str_mv AT ramosgfeljandrop structuringandvalidatingacosteffectivenessmodelofprimaryasthmapreventionamongstchildren
AT kuipersandra structuringandvalidatingacosteffectivenessmodelofprimaryasthmapreventionamongstchildren
AT dompelingedward structuringandvalidatingacosteffectivenessmodelofprimaryasthmapreventionamongstchildren
AT vanasseltantoinettedi structuringandvalidatingacosteffectivenessmodelofprimaryasthmapreventionamongstchildren
AT degrauwwimjc structuringandvalidatingacosteffectivenessmodelofprimaryasthmapreventionamongstchildren
AT knottnerusj structuringandvalidatingacosteffectivenessmodelofprimaryasthmapreventionamongstchildren
AT vanschayckonnocp structuringandvalidatingacosteffectivenessmodelofprimaryasthmapreventionamongstchildren
AT schermertjardrj structuringandvalidatingacosteffectivenessmodelofprimaryasthmapreventionamongstchildren
AT severensjohanl structuringandvalidatingacosteffectivenessmodelofprimaryasthmapreventionamongstchildren