Publications

We are leveraging evidence and influencing the national dialogue about value.

17-24 of 26 Publications

Health Affairs Blog 2012

Saving Medicare Dollars: Moving From the SGR to Bundled Payments

The goal of Medicare is to provide protection for elderly Americans against the financial risk associated with illness, and in the process provide beneficiaries with access to high quality care.  Our challenge is to accomplish those goals in a fiscally sustainable manner. In this article, Michael Chernew, Darius Lakdawalla, and Dana Goldman emphasize that the short-term need to address payment cuts called for by Medicare's physician payment system should not distract from the need for broader payment reform in Medicare over the coming decades.

READ MORE

BMC Medical Research Methodology 2012

Meta-regression models to address heterogeneity and inconsistency in network meta-analysis of survival outcomes

Recently, network meta-analysis of survival data with a multidimensional treatment effect was introduced. With these models the hazard ratio is not assumed to be constant over time, thereby reducing the possibility of violating transitivity in indirect comparisons. However, bias is still present if there are systematic differences in treatment effect modifiers across comparisons. 

READ MORE

Research Synthesis Methods 2012

Accounting for correlation in network meta-analysis with multi-arm trials

Multi-arm trials are particularly valuable forms of evidence for network meta-analysis (NMA). Trial results are available either as arm-level summaries, where effect measures are reported for each arm or as contrast-level summaries, where the differences in effect between arms compare with the control arm chosen for the trial.

READ MORE

BMC Medical Research Methodology 2011

Network meta-analysis of survival data with fractional polynomials

Pairwise meta-analysis, indirect treatment comparisons and network meta-analysis for aggregate level survival data are often based on the reported hazard ratio, which relies on the proportional hazards assumption. This assumption is implausible when hazard functions intersect, and can have a huge impact on decisions based on comparisons of expected survival, such as cost-effectiveness analysis.

READ MORE

Research Synthesis Methods 2011

Network meta-analysis of parametric survival curves

To inform health-care decision-making, treatments are often compared with synthesizing results from a number of randomized controlled trials. The meta-analysis may not only be focused on a particular pairwise comparison but can also include multiple treatment comparisons by means of network meta-analysis. For time-to-event outcomes such as survival, pooling is typically based on the hazard ratio (HR).

READ MORE

Value in Health 2011

Interpreting Indirect Treatment Comparisons and Network Meta-Analysis for Health-Care Decision Making: Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: Part 1

Evidence-based health-care decision making requires comparisons of all relevant competing interventions. In the absence of randomized, controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for judiciously selecting the best choice(s) of treatment. 

READ MORE

Health Affairs 2011

How Cancer Patients Value Hope and The Implications For Cost-Effectiveness Assessments of High-Cost Cancer Therapies

Assessments of the medical and economic value of therapies in diseases such as cancer traditionally focus on average or median gains in patients’ survival. This focus ignores the value that patients may place on a therapy with a wider “spread” of outcomes that offer the potential of a longer period of survival. We call such treatments “hopeful gambles” and contrast them with “safe bets” that offer similar average survival but less chance of a large gain.

READ MORE

Value in Health 2011

Conducting Indirect-Treatment-Comparison and Network-Meta-Analysis Studies: Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices—Part 2

Evidence-based health care decision making requires comparison of all relevant competing interventions. In the absence of randomized controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for judiciously selecting the best treatment(s).

READ MORE