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Value of information
An innovative approach to prioritizing comparative effectiveness research
AHRQ Annual MeetingSeptember 29, 2010
Organizers & Presenters
William Lawrence, MD, MS Joanna E. Siegel, RN, SM, SD Ava John-Baptiste, PhD David O. Meltzer, MD, PhD Gillian D. Sanders, PhD
Session Overview
The promise and challenge of using value of information to inform comparative effectiveness research priorities
Ava John-Baptiste, PhD
Value of Information Analysis to Inform Priorities for Health Research: Moving from Theory to Practice
David O. Meltzer, MD, PhD
Using Value of Information to Prioritize Future Research: A Case Study
Gillian Sanders, PhD
Session Goals
Outline the theoretical basis of VOI Describe use of VOI Discuss barriers to applying VOI Consider possible solutions Present AHRQ funded VOI research
Research
Can improve health care decision making
… at a cost
Prioritizing Research
Research topics– Span a variety of conditions– Pertain to a variety of populations and
subgroups– Prevention, diagnosis and treatment – Drugs, devices, procedures or strategies
How can research funding organizations systematically target investments in research where the
impact of reducing the uncertainties in decisions will have
the greatest benefits?
Topic
For diabetic patients, what is the effectiveness of between visit patient outreach compared to standard patient care on adherence to therapy?
Topic
What is the comparative effectiveness of typical and atypical antipsychotics for schizophrenia, bipolar disorder and other disorders?
Topic
What is the comparative effectiveness of percutaneous coronary interventions and coronary artery bypass grafting for coronary artery disease?
AHRQ Priority Setting Criteria
Appropriateness Importance
– Disease burden– Cost– Stakeholder support– Uncertainty/controversy
Desirability of new research Feasibility Potential value
Value of Information
A measure of the value of acquiring more information to better inform a health care decision
…based on an estimate of the foregone benefit of making the wrong decision
Value of Information
Health care decisions are uncertain We choose what we believe is the best option With more information we may choose a different
option
Value of Information = p Wrong Decision x Expected Value Wrong Decision
VOI Components
1. Decision with two or more options 2. A model relating the expected value of
each option to uncertain parameters3. A method of calculation
Expected Value
ModelParameters + Uncertainty
Value of Information = p Wrong Decision x Expected Value Wrong Decision
Opportunities
Encourages structured decision making Potential to increase transparency Can quantify research benefits relative to
Potential to reduce uncertainty Impact on decision making Cost
Challenges
Complex models are resource intensive Simple models may exclude important
elements of expected value Estimating uncertainty can be difficult
Questions?
Comments?