Cost‐effectiveness acceptability curves – caveats quantified
量化了成本效果可接受曲线（CEAC）与最大化期望净收益方法的差异，指出其在两方案比较中的偏差界限，并揭示多方案时可能导致非传递性选择和不满足无关选项独立性，提醒决策者谨慎使用。
Cost-effectiveness acceptability curves (CEACs) have become widely used in applied health technology assessment and at the same time are criticized as unreliable decision-making tool. In this paper we show how using CEACs differs from maximizing expected net benefit (NB) and when it can lead to inconsistent decisions. In the case of comparing two alternatives we show the limits of the discrepancy between CEAC and expected NB approach and link it with expected value of perfect information. We also show how the shape of CEAC is influenced by the skewness of estimate of expected NB distribution, the correlation between cost and effect estimates and their variance. In the case of more than two options we show when using CEACs can lead to non-transitive choices in pair-wise comparisons and when it lacks independence of irrelevant alternatives property in joint comparisons.