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Multilevel models for estimating incremental net benefits in multinational studies

✍ Scribed by Richard Grieve; Richard Nixon; Simon G. Thompson; John Cairns

Book ID
102230068
Publisher
John Wiley and Sons
Year
2007
Tongue
English
Weight
181 KB
Volume
16
Category
Article
ISSN
1057-9230

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✦ Synopsis

Abstract

Multilevel models (MLMs) have been recommended for estimating incremental net benefits (INBs) in multicentre cost‐effectiveness analysis (CEA). However, these models have assumed that the INBs are exchangeable and that there is a common variance across all centres. This paper examines the plausibility of these assumptions by comparing various MLMs for estimating the mean INB in a multinational CEA. The results showed that the MLMs that assumed the INBs were exchangeable and had a common variance led to incorrect inferences. The MLMs that included covariates to allow for systematic differences across the centres, and estimated different variances in each centre, made more plausible assumptions, fitted the data better and led to more appropriate inferences. We conclude that the validity of assumptions underlying MLMs used in CEA need to be critically evaluated before reliable conclusions can be drawn. Copyright © 2006 John Wiley & Sons, Ltd.

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