Article type
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Abstract
Introduction:
Objectives:
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Results:
Discussion: If systematic reviews are to change clinical practice and health policy, economic evaluation is essential. We aimed to construct a discrete event simulation (DBS) of dyspepsia management alongside a systematic review. DBS allows accurate prediction of costs and outcomes for individual patients over long periods of time. In DBS, patients flow between a series of health states and the costs and diagnostic events accruing can be recorded and analysed. Different patients follow different paths through the model with probabilities which depend upon the input parameters and the choice of strategy. Uncertainties in the data can be explored by sensitivity analysis. The data requirements of an economic model are much broader than those of a systematic review, where a focussed question is to be addressed. A difficult balance between systematic data collection and the limits of time and funding may need to be struck. The DBS model for dyspepsia can be updated easily as new trial data becomes available. Reviewers need to consider what economic evaluation is needed early in the planning of a review. However, such a tool may enable clinicians and purchasers to understand the impact on prescribing and referral costs of different strategies for managing dyspeptic patients. If appropriate quality standards were developed, simulation models could, in the future, incorporate economic models into the Cochrane Library.
Objectives:
Methods:
Results:
Discussion: If systematic reviews are to change clinical practice and health policy, economic evaluation is essential. We aimed to construct a discrete event simulation (DBS) of dyspepsia management alongside a systematic review. DBS allows accurate prediction of costs and outcomes for individual patients over long periods of time. In DBS, patients flow between a series of health states and the costs and diagnostic events accruing can be recorded and analysed. Different patients follow different paths through the model with probabilities which depend upon the input parameters and the choice of strategy. Uncertainties in the data can be explored by sensitivity analysis. The data requirements of an economic model are much broader than those of a systematic review, where a focussed question is to be addressed. A difficult balance between systematic data collection and the limits of time and funding may need to be struck. The DBS model for dyspepsia can be updated easily as new trial data becomes available. Reviewers need to consider what economic evaluation is needed early in the planning of a review. However, such a tool may enable clinicians and purchasers to understand the impact on prescribing and referral costs of different strategies for managing dyspeptic patients. If appropriate quality standards were developed, simulation models could, in the future, incorporate economic models into the Cochrane Library.