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      Accounting for Costs, QALYs, and Capacity Constraints : Using Discrete-Event Simulation to Evaluate Alternative Service Delivery and Organizational Scenarios for Hospital-Based Glaucoma Services

      , , , , ,

      Medical Decision Making

      SAGE Publications

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          Most cited references 29

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          Reduction of Intraocular Pressure and Glaucoma Progression

           Anders Heijl (2002)
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            Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries.

            This paper compares policies to tackle excessive waiting times for elective surgery in 12 OECD countries. It is found that waiting times may be reduced by acting on the supply of or on the demand for surgery (or both). On the supply side, evidence suggests that both capacity and financial incentives towards productivity can play an important role. On the demand side, inducing a raising of clinical thresholds may reduce waiting times but may also provoke tension between clinicians and policy makers. Preliminary evidence also suggests that an increase in private health insurance coverage may reduce waiting times.
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              Calibrating models in economic evaluation: a seven-step approach.

              In economic evaluation, mathematical models have a central role as a way of integrating all the relevant information about a disease and health interventions, in order to estimate costs and consequences over an extended time horizon. Models are based on scientific knowledge of disease (which is likely to change over time), simplifying assumptions and input parameters with different levels of uncertainty; therefore, it is sensible to explore the consistency of model predictions with observational data. Calibration is a useful tool for estimating uncertain parameters, as well as more accurately defining model uncertainty (particularly with respect to the representation of correlations between parameters). Calibration involves the comparison of model outputs (e.g. disease prevalence rates) with empirical data, leading to the identification of model parameter values that achieve a good fit. This article provides guidance on the theoretical underpinnings of different calibration methods. The calibration process is divided into seven steps and different potential methods at each step are discussed, focusing on the particular features of disease models in economic evaluation. The seven steps are (i) Which parameters should be varied in the calibration process? (ii) Which calibration targets should be used? (iii) What measure of goodness of fit should be used? (iv) What parameter search strategy should be used? (v) What determines acceptable goodness-of-fit parameter sets (convergence criteria)? (vi) What determines the termination of the calibration process (stopping rule)? (vii) How should the model calibration results and economic parameters be integrated? The lack of standards in calibrating disease models in economic evaluation can undermine the credibility of calibration methods. In order to avoid the scepticism regarding calibration, we ought to unify the way we approach the problems and report the methods used, and continue to investigate different methods.
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                Author and article information

                Journal
                Medical Decision Making
                Med Decis Making
                SAGE Publications
                0272-989X
                1552-681X
                March 20 2013
                March 20 2013
                : 33
                : 8
                : 986-997
                Article
                10.1177/0272989X13478195
                © 2013

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