Transcript Carole Longson

Bayesian Statistics
Vague, variable, subjective
to boot…
…and, when used as a basis
for decision modelling,
helpful for decision makers
in NICE technology
appraisals
Dr Carole Longson
Appraisal Programme Director
Attributes of
Technology Appraisal
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Independent advisory committee
formulates guidance
Transparent and inclusive
process
Consultation with diverse groups
All groups invited to submit
evidence
Attributes of
Technology Appraisal
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‘Inclusive’ evidence base, not just
clinical trials
Multiple perspectives are often
conflicting
Decisions are made in the ‘real world’
lack of evidence or conflicting
evidence
conflicting views of the same
evidence
uncertainty
Evidence
Research
Evidence
Patient
Experience
Clinical
Practice
What matters?
Need
Size of
effect
Value of
effect
Service
impact
The Appraisal Challenge
• Balance the
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evidence from
different inputs
Make robust
decisions with
less than perfect
information
Ensure process
is transparent
and decisions
are justifiable
Balancing the Evidence
Independent
technology
assessment
Manufacturers
data
Modelling the unknown
Health
professionals
opinion
Patients and
carers views
and preferences
Why we need decision
analytic models
• Uncertainty is the
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norm in technology
appraisal!
Good models help
decision makers deal
with complex and
sometimes conflicting
evidence
Why we need decision
analytic models?
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To model or not to model?
Yes, no choice for many appraisals
Decision analytic models help make
better decisions at time t in the
absence of perfect information
This is just what the appraisal
process needs
Modelling Techniques and
Decision Making
‘The good, the bad, the useful
and the not so useful’
We get them all in technology appraisals
The Appraisal Challenge
What have we learnt?
"There is nothing more difficult to plan, more
doubtful of success, nor more dangerous to
manage, than the creation of a new system.
For the initiator has the enmity of all who
would profit by the preservation of the old
institutions, and merely lukewarm defenders
in those who should gain by the new ones."
Machiavelli