PMID- 11921321
OWN - NLM
STAT- MEDLINE
DCOM- 20020416
LR  - 20191105
IS  - 1057-9230 (Print)
IS  - 1057-9230 (Linking)
VI  - 11
IP  - 3
DP  - 2002 Apr
TI  - Statistical determination of cost-effectiveness frontier based on net health 
      benefits.
PG  - 249-64
AB  - Statistical methods are given for producing a cost-effectiveness frontier for an 
      arbitrary number of programs. In the deterministic case, the net health benefit 
      (NHB) decision rule is optimal; the rule funds the program with the largest 
      positive NHB at each lambda, the amount a decision-maker is willing to pay for an 
      additional unit of effectiveness. For bivariate normally distributed cost and 
      effectiveness variables and a specified lambda, a statistical procedure is 
      presented, based on the method of constrained multiple comparisons with the best 
      (CMCB), for determining the program with the largest NHB. A one-tailed t test is 
      used to determine if the NHB is positive. To obtain a statistical frontier in the 
      lambda-NHB plane, we develop a method to produce the region in which each program 
      has the largest NHB, by pivoting a CMCB confidence interval. A one-sided version 
      of Fieller's theorem is used to determine the region where the NHB of each 
      program is positive. At each lambda, the pointwise error rate is bounded by a 
      prespecified alpha. Upper bounds on the familywise error rate, the probability of 
      an error at any value of lambda, are given. The methods are applied to a 
      hypothetical clinical trial of antipsychotic agents.
CI  - Copyright 2002 John Wiley & Sons, Ltd.
FAU - Laska, Eugene M
AU  - Laska EM
AD  - Statistical Sciences & Epidemiology Division, The Nathan S. Kline Institute for 
      Psychiatric Research, Orangeburg, NY 10962, USA. laska@nki.rfmh.org
FAU - Meisner, Morris
AU  - Meisner M
FAU - Siegel, Carole
AU  - Siegel C
FAU - Wanderling, Joseph
AU  - Wanderling J
LA  - eng
GR  - P50 MH 51359/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - England
TA  - Health Econ
JT  - Health economics
JID - 9306780
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Algorithms
MH  - Antipsychotic Agents/economics/therapeutic use
MH  - Confidence Intervals
MH  - Cost-Benefit Analysis/*statistics & numerical data
MH  - Decision Making
MH  - Health Care Costs/*statistics & numerical data
MH  - Humans
MH  - *Models, Statistical
MH  - Program Evaluation/*economics/methods
MH  - Randomized Controlled Trials as Topic/*statistics & numerical data
MH  - Schizophrenia/drug therapy/economics
MH  - Stochastic Processes
MH  - *Treatment Outcome
EDAT- 2002/03/29 10:00
MHDA- 2002/04/17 10:01
CRDT- 2002/03/29 10:00
PHST- 2002/03/29 10:00 [pubmed]
PHST- 2002/04/17 10:01 [medline]
PHST- 2002/03/29 10:00 [entrez]
AID - 10.1002/hec.659 [pii]
AID - 10.1002/hec.659 [doi]
PST - ppublish
SO  - Health Econ. 2002 Apr;11(3):249-64. doi: 10.1002/hec.659.