TY - JOUR
T1 - A Bayesian approach to net health benefits
T2 - An illustration and application to modeling HIV prevention
AU - Johnson-Masotti, Ana P.
AU - Laud, Purushottam W.
AU - Hoffmann, Raymond G.
AU - Hayat, Matthew J.
AU - Pinkerton, Steven D.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2004/11
Y1 - 2004/11
N2 - Purpose. To conduct a cost-effectiveness analysis of HIV prevention when costs and effects cannot be measured directly. To quantify the total estimation of uncertainty due to sampling variability as well as inexact knowledge of HIV transmission parameters. Methods. The authors focus on estimating the incremental net health benefit (INHB) in a randomized trial of HIV prevention with intervention and control conditions. Using a Bernoulli model of HIV transmission, changes in the participants' risk behaviors are converted into the number of HIV infections averted. A sampling model is used to account for variation in the behavior measurements. Bayes's theorem and Monte Carlo methods are used to attain the stated objectives. Results. The authors obtained a positive mean INHB of 0.0008, indicating that advocacy training is just slightly favored over the control condition for men, assuming a $50,000 per quality-adjusted life year (QALY) threshold. To be confident of a positive INHB, the decision maker would need to spend more than $100,000 per QALY.
AB - Purpose. To conduct a cost-effectiveness analysis of HIV prevention when costs and effects cannot be measured directly. To quantify the total estimation of uncertainty due to sampling variability as well as inexact knowledge of HIV transmission parameters. Methods. The authors focus on estimating the incremental net health benefit (INHB) in a randomized trial of HIV prevention with intervention and control conditions. Using a Bernoulli model of HIV transmission, changes in the participants' risk behaviors are converted into the number of HIV infections averted. A sampling model is used to account for variation in the behavior measurements. Bayes's theorem and Monte Carlo methods are used to attain the stated objectives. Results. The authors obtained a positive mean INHB of 0.0008, indicating that advocacy training is just slightly favored over the control condition for men, assuming a $50,000 per quality-adjusted life year (QALY) threshold. To be confident of a positive INHB, the decision maker would need to spend more than $100,000 per QALY.
KW - Bayesian
KW - Cost-effectiveness
KW - HIV
KW - Net benefit
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U2 - 10.1177/0272989X04271040
DO - 10.1177/0272989X04271040
M3 - Article
C2 - 15534344
AN - SCOPUS:8744303778
SN - 0272-989X
VL - 24
SP - 634
EP - 653
JO - Medical Decision Making
JF - Medical Decision Making
IS - 6
ER -