“Lost in Translation”

Authors: Andrea Manca Andrew R Willan

Publish Date: 2013/02/27

Volume: 12, Issue: 3, Pages: 183-202

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Abstract

Costeffectiveness analysis has gained status over the last 15 years as an important tool for assisting resource allocation decisions in a budgetlimited environment such as healthcare Randomised multicentre multinational controlled trials are often the main vehicle for collecting primary patientlevel information on resource use cost and clinical effectiveness associated with alternative treatment strategies However trialwide cost effectiveness results may not be directly applicable to any one of the countries that participate in a multinational trial requiring some form of additional modelling to customise the results to the country of interestThis article proposes an algorithm to assist with the choice of the appropriate analytical strategy when facing the task of adapting the study results from one country to another The algorithm considers different scenarios characterised by a whether the country of interest participated in the trial and b whether individual patientlevel data IPD from the trial are availableThe analytical options available range from the use of regressionbased techniques to the application of decisionanalytic models Decision models are typically used when the evidence base is available exclusively in summary format whereas regressionbased methods are used mainly when the country of interest actively recruited patients into the trial and there is access to IPD or at least countryspecific summary data

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