Decision-makers, such as the National institute for Health and Care Excellence, require evidence on both effectiveness and cost-effectiveness to inform resource allocation decisions. However, when health is constantly fluctuating it can be challenging to adequately account for these fluctuations in economic evaluations. These recurrent fluctuations in health states occur due to long-term conditions with episodic symptoms (e.g. multiple sclerosis) or through side effects of cycles of treatment (e.g. chemotherapy for cancer). Fluctuations in health can have an important impact on a person’s quality of life. Economic evaluations with cohort averaged and constant health states, which ignore fluctuations, are common. Results could therefore be biased and sensitivity analysis methods can perpetuate the problem. If these fluctuations are not accounted for in economic evaluations, it could result in misleading treatment recommendations to decision-makers.
Aims and objectives
The aim of this PhD is to develop methods to account for recurrent fluctuations in health in economic evaluations through the use of decision modelling. This research will determine the extent to which recurrent fluctuations influence cost-effectiveness results and provide best practice recommendations on how to model conditions with recurrent fluctuations in health.
The student will be supported through appropriate training to carry out the research, which will include:
1) A systematic review of the literature to identify current evidence on the decision modelling methods used to account for fluctuations in health.
2) The adaptation and/or development of a decision model to explore appropriate methods related to model characteristics, for example, model structure, time cycles, and sensitivity analysis methods. The use of individual level simulation models could also be explored.
3) The use of an existing decision model to investigate the impact of the proposed methods on the cost-effectiveness result.
Personal development will be encouraged through training, weekly seminars and networking with researchers from a range of disciplines. The student can also take advantage of the highly regarded short-course programme run by the Bristol Medical School, which offers training in a wide range of research skills.
How to apply for this project
This project will be based in Bristol Medical School - Population Health Sciences in the Faculty of Health Sciences at the University of Bristol.
Please visit the Faculty of Health Sciences website for details of how to apply