Document Detail

Confidence intervals for cost-effectiveness ratios: an application of Fieller's theorem.
MedLine Citation:
PMID:  8880166     Owner:  NLM     Status:  MEDLINE    
Application of cost-effectiveness analysis (CEA) is growing rapidly in health care. Two general approaches to analysis are differentiated by the type of data available: (i) deterministic models based upon secondary analysis of retrospective data from one or more trials and other sources; and (ii) stochastic analyses in which the design of a randomized controlled trial is adapted to collect prospectively patient-specific data on costs and effectiveness. An important methodological difference between these two approaches is in how uncertainty is handled. Deterministic CEA models typically rely upon sensitivity analysis to determine the robustness of findings to alternative assumptions, whereas stochastic (CEA) analysis, as part of prospective studies, permits the use of conventional statistical methods on the cost and effectiveness data for both inference (hypothesis testing) and estimation. This paper presents a procedure for the statistical analysis of cost-effectiveness data, with specific application to those studies for which effectiveness is measured as a binary outcome. Specifically, Fieller's Theorem was used to calculate confidence intervals for ratios of the two random variables of between-treatment differences in observed costs and effectiveness, i.e. the incremental cost-effectiveness ratio.
A R Willan; B J O'Brien
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Health economics     Volume:  5     ISSN:  1057-9230     ISO Abbreviation:  Health Econ     Publication Date:    1996 Jul-Aug
Date Detail:
Created Date:  1997-02-14     Completed Date:  1997-02-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9306780     Medline TA:  Health Econ     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  297-305     Citation Subset:  IM    
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
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MeSH Terms
Computer Simulation
Confidence Intervals*
Cost-Benefit Analysis / methods*
Health Services Research / economics,  methods*
Models, Economic
Outcome Assessment (Health Care) / statistics & numerical data*
Prospective Studies
Randomized Controlled Trials as Topic / statistics & numerical data*
Sample Size
Stochastic Processes*
Erratum In:
Health Econ 1999 Sep;8(6):559

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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