Statistical Methods in health care economic evaluation

1. Describe the logistic regression and the ordinary least squares regression models and illustrate the use of each approach using examples (one for each model) in the context of an economic evaluation of health care intervention.

2. Discuss censoring as it arises in the analysis of time-to-event data. Describe the Kaplan-Meir estimator and explain how it deals with censoring. How can estimates of gain in effectiveness be derived using the estimator? Comparing with other methods describe how this estimator might be used to extrapolate results beyond the end of a clinical trial.

3. Which non-parametric statistical method could be used to estimate the mean cost of a health care intervention using patient level data in the presence of censoring over the duration of the medical study? What are the assumptions underlying each of the approaches and under what circumstances might one approach be preferred to another?

4. What are the difficulties associated with the missing data in the analysis of patient level data? Discuss possible solutions.

5. Why are standard statistical methods for estimating confidence interval inappropriate for the ICER statistics? Discuss alternative methods and have been proposed to calculate the variance of the ICER outlining their advantages and disadvantages. Which would be the preferred method?

6. Why might logistic regression be preferred over ordinary least square estimation in estimating health care events?

7. Why might a parametric estimate of survival time be preferred to a non-parametric estimator of survival time?

8. Discuss the various estimators available for the analysis of censored cost data. Which of these available estimators do you prefer and why?

9. How might uncertainty surrounding the estimate of the ICER be handled? Why some methods be preferred over others?

10. Discuss the problems that might be arise in estimating the analyzing the ICER using clinical trial data.

11. How might a logistic regression be used to quantify levels of effectiveness in an economic evaluation in health care?

12. Discuss Kaplan- Meir estimator its use in estimating gains in clinical outcomes. Comparing with other methods to estimate clinical outcomes describe how the Kaplan-Meir estimator can be used to extrapolate beyond the end of clinical trial.

13. “Provided a parametric survival model can be shown to fit the data it will always be preferred to a non-parametric approach’. Discuss

14. If censoring is present in cost-to-event data, which estimators might you apply to deal with this problem?

15. Describe the various methods used to calculate the variance of the incremental cost-effectiveness ratio outlining their strengths and limitations. Discuss the view that the net benefit statistic outcomes the limitations of the other approaches.

16. What are the major problems associated with applying economic data to a clinical trial?



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