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Lee B, Kim NE, Won S, Gim J. Propensity score matching for comparative studies: a tutorial with R and Rex. JOURNAL OF MINIMALLY INVASIVE SURGERY 2024; 27:55-71. [PMID: 38886996 PMCID: PMC11187614 DOI: 10.7602/jmis.2024.27.2.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 05/29/2024] [Accepted: 06/07/2024] [Indexed: 06/20/2024]
Abstract
Recently, there has been considerable progress in developing new technologies and equipment for the medical field, including minimally invasive surgeries. Evaluating the effectiveness of these treatments requires study designs like randomized controlled trials. However, due to the nature of certain treatments, randomization is not always feasible, leading to the use of observational studies. The effect size estimated from observational studies is subject to selection bias caused by confounders. One method to reduce this bias is propensity scoring. This study aimed to introduce a propensity score matching process between two groups using a practical example with R. Additionally, Rex, an Excel add-in graphical user interface statistical program, is provided for researchers unfamiliar with R programming. Further techniques, such as matching with three or more groups, propensity score weighting and stratification, and imputation of missing values, are summarized to offer approaches for more complex studies not covered in this tutorial.
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Affiliation(s)
- Bora Lee
- Institute of Well-Aging Medicare & CSU G-LAMP Project Group, Chosun University, Gwangju, Korea
- Department of Public Health Sciences, Seoul National University, Seoul, Korea
| | - Nam-eun Kim
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Sungho Won
- Department of Public Health Sciences, Seoul National University, Seoul, Korea
- Institute of Health and Environment, Seoul National University, Seoul, Korea
- RexSoft Inc., Seoul, Korea
| | - Jungsoo Gim
- Institute of Well-Aging Medicare & CSU G-LAMP Project Group, Chosun University, Gwangju, Korea
- Department of Biomedical Science, Chosun University, Gwangju, Korea
- Gwangju Alzheimer’s & Related Dementia Cohort Research Center, Chosun University, Gwangju, Korea
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Ho VH, Giguère Y, Reinharz D. Economic Rationality in Decision-Making Regarding Newborn Screening: A Case Study in Quebec. Int J Neonatal Screen 2024; 10:36. [PMID: 38804358 PMCID: PMC11130899 DOI: 10.3390/ijns10020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/13/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024] Open
Abstract
Health systems in high-resource countries recognize the importance of making decisions about the services offered to the population based on scientific evidence. Producing this evidence is especially challenging in areas such as newborn care where the frequency of conditions is rare. However, methodological advances in the field of economic evaluation could change how this evidence is used in decision-making. This study aimed to investigate how decision-makers in the Canadian province of Quebec perceive the value of recent advances in economic evaluations for perinatal studies and how these advances might affect the offer of neonatal interventions in the public health care system. A qualitative study was conducted. A total of 10 policymakers were interviewed. A neo-institutional conceptual framework highlighting three dimensions, structure, power, and interpretive schemes, was used for data collection and analyses. Structural factors, interpretative schemes, and power management between the groups concerned concur to ensure that providing services to newborns is not hindered by the difficulty of producing evidence. They also ensure that the decisions regarding which disease to screen for take into consideration the specificity of neonatology, in particular, the social value given to children not captured by available evidence.
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Affiliation(s)
- Van Hoa Ho
- Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, QC G1V 5C3, Canada;
| | - Yves Giguère
- Department of Molecular Biology, Medical Biochemistry and Pathology, Faculty of Medicine, Laval University, Quebec City, QC G1V 5C3, Canada;
- CHU de Québec-Université Laval Research Center, Quebec City, QC G1V 4G2, Canada
| | - Daniel Reinharz
- Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, QC G1V 5C3, Canada;
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Trowman R, Migliore A, Ollendorf DA. The value and impact of health technology assessment: discussions and recommendations from the 2023 Health Technology Assessment International Global Policy Forum. Int J Technol Assess Health Care 2023; 39:e75. [PMID: 38130164 DOI: 10.1017/s0266462323002763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Health technology assessment (HTA) programs inform decision making about the value and reimbursement of new and existing health technologies; however, they are under increasing pressure to demonstrate that they are a cost-effective use of finite healthcare resources themselves. The 2023 HTAi Global Policy Forum (GPF) discussed the value and impact of HTA, including how it is assessed and communicated, and how it could be enhanced in the future. This article summarizes the discussions held at the 2023 HTAi GPF, where the challenges and opportunities related to the value and impact of HTA were debated. Core themes and recommendations identified that defining the purpose of value and impact assessment is an essential first step prior to undertaking it, and that it can be done through the use and expansion of existing tools. Further work around aligning HTA programs with underlying societal values is needed to ensure the long-term value and impact of HTA. HTA could also have a role in assessing the efficiency of the wider health system by applying HTA methods or concepts to broader budgetary allocations and organizational aspects of health care. Stakeholders (particularly patients, industry, and clinicians but also payers, wider society, and the media) should ideally be actively engaged when undertaking the value and impact assessment of HTA. More concerted efforts in communicating the role and remit of HTA bodies would also help stakeholders to better understand the value and impact of HTA, which in turn could improve the implementation of HTA recommendations and application to future actions in the lifecycle of technologies.
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Affiliation(s)
| | - Antonio Migliore
- Health Technology Assessment International (HTAi), Edmonton, AB, Canada
| | - Daniel A Ollendorf
- Tufts Medical Center, Center for the Evaluation of Value and Risk in Health, Boston, MA, USA
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Barlow E, Morton A, Dabak S, Engels S, Isaranuwatchai W, Teerawattananon Y, Chalkidou K. What is the value of explicit priority setting for health interventions? A simulation study. Health Care Manag Sci 2022; 25:460-483. [PMID: 35633404 PMCID: PMC9474606 DOI: 10.1007/s10729-022-09594-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/06/2022] [Indexed: 11/28/2022]
Abstract
Many countries seek to secure efficiency in health spending through establishing explicit priority setting institutions (PSIs). Since such institutions divert resources from frontline services which benefit patients directly, it is legitimate and reasonable to ask whether they are worth the money. We address this question by comparing, through simulation, the health benefits and costs from implementing two alternative funding approaches – one scenario in which an active PSI enables cost-effectiveness-threshold based funding decisions, and a counterfactual scenario where there is no PSI. We present indicative results for one dataset from the United Kingdom (published in 2015) and one from Malawi (published in 2018), which show that the threshold rule reliably resulted in decreased health system costs, improved health benefits, or both. Our model is implemented in Microsoft Excel and designed to be user-friendly, and both the model and a user guide are made publicly available, in order to enable others to parameterise the model based on the local setting. Although inevitably stylised, we believe that our modelling and results offer a valid perspective on the added value of explicit PSIs.
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Affiliation(s)
- Euan Barlow
- Department of Management Science, Strathclyde Business School, University of Strathclyde, Glasgow, UK.
| | - Alec Morton
- Department of Management Science, Strathclyde Business School, University of Strathclyde, Glasgow, UK
| | - Saudamini Dabak
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Sven Engels
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Kalipso Chalkidou
- iDSI, School of Public Health, Imperial College London, London, UK.,Center for Global Development, Washington, DC, USA
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