Expected value of information and decision making in HTA
研究了在卫生技术评估中，当新干预措施的净效益不确定时，考虑逆转成本如何影响信息期望价值，并比较三种决策策略以优化试验设计和决策。
Decision makers within a jurisdiction facing evidence of positive but uncertain incremental net benefit of a new health care intervention have viable options where no further evidence is anticipated to:(1)adopt the new intervention without further evidence;(2)adopt the new intervention and undertake a trial; or(3)delay the decision and undertake a trial.Value of information methods have been shown previously to allow optimal design of clinical trials in comparing option (2) against option (1), by trading off the expected value and cost of sample information. However, this previous research has not considered the effect of cost of reversal on expected value of information in comparing these options. This paper demonstrates that, where a new intervention is adopted, the expected value of information is reduced under optimal decision making with costs of reversing decisions. Further, the paper shows that comparing expected net gain of optimally designed trials for option (2) vs (1) conditional on cost of reversal, and (3) vs (1) conditional on opportunity cost of delay allow systematic identification of an optimal decision strategy and trial design.