STATISTICAL METHODS NEEDED IN HEALTH ECONOMICS

Author(s)

Gause D, Gause PSee-It-Analytics, Easton , PA, USA

OBJECTIVE:  To review important statistical methods used in health economics. BACKGROUND: During two decades in health economics at Novartis Pharmaceuticals, statistician Doug Gause regularly presented friendly one-page illustrations of statistical  concepts in health economics. Thirty of these  “Analysis Notes” are presented on this poster, along with a magnifying glass for easier viewing. ANALYSIS NOTES:  Making inferences:  Confidence interval estimation instead of hypothesis testing, and bootstrapping to avoid assumptions.  Analyzing costs:  Two-part GLM models instead of transformations.  Measuring compliance:  Avoiding adherence bias in calculating MPR. Competing risks of discontinuing, adding, switching, or remaining on drug.  Data visualization: Regression trees, drug-o-grams, mosaic plots, parallel coordinate plots, and sequence plots to visualize patterns. ( Lets reserve pie charts for the Baker's Convention ! )  Covariate adjustment:  Marginal means/IPTW, confounders vs. colliders, instrument variables, and time dependent covariates to incorporate changes over time.   Historical data:  Bayesian analysis for bias adjusting, and meta-analysis to incorporate results from multiple studies.  Avoiding pitfalls:  Be aware of the “individualized”  fallacy and the “ecological“ fallacy.  Differential follow-up:  Person-time and survival analysis to accommodate censoring.  Predictive modeling:   Nearest neighbor vs. recursive partitioning vs. neural networks.  Project planning:  Sample size to handling multiplicity. Clustered/longitudinal data:  Random effects models to account for correlated observations from the same physician or repeated measurements from the same patient.  Cost-effectiveness:  Angles instead of ratios, and incremental net benefit to handle multiple effectiveness measures.  Heterogeneous data:  Quantile and polytomous regression to compare different MPR distributions. CONCLUSION:  Statistics needs to be taught in small friendly doses tied to practical problems. Each analysis note presented by Doug Gause has sketches drawn by artist Pat Gause.

Conference/Value in Health Info

2010-05, ISPOR 2010, Atlanta, GA, USA

Value in Health, Vol. 13, No. 3 (May 2010)

Code

PMC47

Topic

Clinical Outcomes

Topic Subcategory

Relating Intermediate to Long-term Outcomes

Disease

Multiple Diseases

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