PMID- 31220101
OWN - NLM
STAT- MEDLINE
DCOM- 20200214
LR  - 20200309
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 14
IP  - 6
DP  - 2019
TI  - Value of information analysis in telehealth for chronic heart failure management.
PG  - e0218083
LID - 10.1371/journal.pone.0218083 [doi]
LID - e0218083
AB  - OBJECTIVES: Value of information (VOI) analysis provides information on 
      opportunity cost of a decision in healthcare by estimating the cost of reducing 
      parametric uncertainty and quantifying the value of generating additional 
      evidence. This study is an application of the VOI methodology to the problem of 
      choosing between home telemonitoring and nurse telephone support over usual care 
      in chronic heart failure management in the Netherlands. METHODS: The expected 
      value of perfect information (EVPI) and the expected value of partially perfect 
      information (EVPPI) analyses were based on an informal threshold of euro20K per 
      quality-adjusted life-year. These VOI-analyses were applied to a probabilistic 
      Markov model comparing the 20-year costs and effects in three interventions. The 
      EVPPI explored the value of decision uncertainty caused by the following group of 
      parameters: treatment-specific transition probabilities between New York Heart 
      Association (NYHA) defined disease states, utilities associated with the disease 
      states, number of hospitalizations and ER visits, health state specific costs, 
      and the distribution of patients per NYHA group. We performed the analysis for 
      two population sizes in the Netherlands-patients in all NYHA classes of severity, 
      and patients in NYHA IV class only. RESULTS: The population EVPI for an effective 
      population of 2,841,567 CHF patients in All NYHA classes of severity over the 
      next 20 years is more than euro4.5B, implying that further research is highly 
      cost-effective. In the NYHA IV only analysis, for the effective population of 
      208,003 patients over next 20 years, the population EVPI at the same informal 
      threshold is approx. euro590M. The EVPPI analysis showed that the only relevant 
      group of parameters that contribute to the overall decision uncertainty are 
      transition probabilities, in both All NYHA and NYHA IV analyses. CONCLUSIONS: 
      Results of our VOI exercise show that the cost of uncertainty regarding the 
      decision on reimbursement of telehealth interventions for chronic heart failure 
      patients is high in the Netherlands, and that future research is needed, mainly 
      on the transition probabilities.
FAU - Grustam, Andrija S
AU  - Grustam AS
AUID- ORCID: 0000-0002-5777-3368
AD  - Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 
      Rotterdam, the Netherlands.
AD  - Professional Health Solutions & Services Department, Philips Research, Eindhoven, 
      the Netherlands.
FAU - Buyukkaramikli, Nasuh
AU  - Buyukkaramikli N
AD  - Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 
      Rotterdam, the Netherlands.
AD  - Institute of Medical Technology Assessment, Erasmus University Rotterdam, 
      Rotterdam, the Netherlands.
FAU - Koymans, Ron
AU  - Koymans R
AD  - Professional Health Solutions & Services Department, Philips Research, Eindhoven, 
      the Netherlands.
FAU - Vrijhoef, Hubertus J M
AU  - Vrijhoef HJM
AD  - Department of Patient & Care, Maastricht UMC, Maastricht, the Netherlands.
AD  - Department of Family Medicine and Chronic Care, Vrije Universiteit Brussels, 
      Brussels, Belgium.
AD  - Panaxea b.v., Amsterdam, the Netherlands.
FAU - Severens, Johan L
AU  - Severens JL
AD  - Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 
      Rotterdam, the Netherlands.
AD  - Institute of Medical Technology Assessment, Erasmus University Rotterdam, 
      Rotterdam, the Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190620
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Chronic Disease
MH  - Cost-Benefit Analysis
MH  - *Decision Support Systems, Clinical
MH  - Heart Failure/*therapy
MH  - Humans
MH  - Netherlands
MH  - *Telemedicine/economics
PMC - PMC6586290
COIS- We have the following interests: This study was funded by Philips. A.Grustam and 
      R.Koymans are/were affiliated to Philips. J. Severens was compensated by Philips 
      in the form of a consultancy fee paid to his institution. H. Vrijhoef is an owner 
      of Panaxea b.v.. There are no patents, products in development or marketed 
      products to declare. This does not alter our adherence to all the PLOS ONE 
      policies on sharing data and materials.
EDAT- 2019/06/21 06:00
MHDA- 2020/02/15 06:00
PMCR- 2019/06/20
CRDT- 2019/06/21 06:00
PHST- 2018/08/28 00:00 [received]
PHST- 2019/05/26 00:00 [accepted]
PHST- 2019/06/21 06:00 [entrez]
PHST- 2019/06/21 06:00 [pubmed]
PHST- 2020/02/15 06:00 [medline]
PHST- 2019/06/20 00:00 [pmc-release]
AID - PONE-D-18-25307 [pii]
AID - 10.1371/journal.pone.0218083 [doi]
PST - epublish
SO  - PLoS One. 2019 Jun 20;14(6):e0218083. doi: 10.1371/journal.pone.0218083. 
      eCollection 2019.