OBJECTIVES:

Decision makers frequently face decisions about optimal resource allocation. A model-based economic evaluation is often used to guide decision makers in their choices by systematically evaluating the magnitude and tradeoffs of the expected health effects and costs of decision options considered. To properly structure the decision-making process, there is a need for a coherent framework that formalizes the overarching iterative steps of model-based decision-making.

METHODS:

The method to develop the framework consisted of three steps. Step 1 involved compiling the existing guidelines provided by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the Society for Medical Decision-Making (SMDM) Modeling Good Research Practices Task Force, and the ISPOR Value of Information Task Force. Step 2 involved identifying other previous work related to frameworks and guidelines for model-based decision analyses through a literature search performed in PubMed. Step 3 involved formalizing an overarching iterative model-based decision-making framework.

RESULTS:

The proposed iterative decision-making framework combines multiple published recommendations to formalize key parts involved in undertaking a model-based decision analysis. Our framework formally combines the decision problem conceptualization (Part I), the model conceptualization and development (Part II), and the process of model-based decision analysis (Part III). Furthermore, the framework extends the previous work by underscoring the need to propagate the principles of evidence-based medicine and to regularly update the evidence and include value of information analysis as a required component of model-based decision analysis.

CONCLUSIONS:

The iterative decision-making framework propagates the principles of evidence-based medicine and highlights the importance of the iterative process in decision-making. The application of this framework can be used to guide health decision analysts, and it has the potential to improve medical decision-making.