Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Click here to browse AJSM online!

Sign In to gain access to subscriptions and/or personal tools.
Medical Decision Making
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Halpern, E. F.
Right arrow Articles by Gazelle, G. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Halpern, E. F.
Right arrow Articles by Gazelle, G. S.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Other

Representing Both First- and Second-order Uncertainties by Monte Carlo Simulation for Groups of Patients

Elkan F. Halpern, PhD

Milton C. Weinstein, PhD

Maria G.M. Hunink, MD, PhD

G. Scott Gazelle, MD, PhD

Actual implementation of probabilistic sensitivity analysis may lead to misleading or improper conclusions when it is applied to groups of patients rather than individual patients. The practice of combining first- and second-order simulations when modeling the outcome for a group of more than one patient yields an erroneous marginal distribution whenever the parameter values are randomly sampled for each patient while the results are presented as simulated means for the group of patients. This practice results in underrepresenting the second-order uncertainty. It may also distort the shape (especially the symmetry or extent of the tails) in the simulated distribution. As a result, it may lead to premature or incorrect conclusions of superiority. It may also result in inappropriate estimates of the value of further research to inform parameter values. Key words: Simulation; probabilistic sensitivity analysis; Monte Carlo; confidence interval ; cost-effectiveness; implementation. (Med Decis Making 2000;20:314-322)

Medical Decision Making, Vol. 20, No. 3, 314-322 (2000)
DOI: 10.1177/0272989X0002000308
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 BiostatisticsHome page
A. van den Hout and F. E. Matthews
Estimating dementia-free life expectancy for Parkinson's patients using Bayesian inference and microsimulation
Biostat., October 1, 2009; 10(4): 729 - 743.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
E. Losina, R. P. Walensky, C. L. Kessler, P. S. Emrani, W. M. Reichmann, E. A. Wright, H. L. Holt, D. H. Solomon, E. Yelin, A. D. Paltiel, et al.
Cost-effectiveness of Total Knee Arthroplasty in the United States: Patient Risk and Hospital Volume
Arch Intern Med, June 22, 2009; 169(12): 1113 - 1121.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
D. J. Cohen and M. R. Reynolds
Interpreting the results of cost-effectiveness studies.
J. Am. Coll. Cardiol., December 16, 2008; 52(25): 2119 - 2126.
[Abstract] [Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
M. Vera-Llonch, E. Massarotti, F. Wolfe, N. Shadick, R. Westhovens, O. Sofrygin, R. Maclean, Y. Yuan, and G. Oster
Cost-effectiveness of abatacept in patients with moderately to severely active rheumatoid arthritis and inadequate response to methotrexate
Rheumatology, April 1, 2008; 47(4): 535 - 541.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
J. T. Schousboe, J. A. Nyman, R. L. Kane, and K. E. Ensrud
Cost-Effectiveness of Alendronate Therapy for Osteopenic Postmenopausal Women
Ann Intern Med, May 3, 2005; 142(9): 734 - 741.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
G. S. Gazelle, P. M. McMahon, U. Siebert, and M. T. Beinfeld
Cost-effectiveness Analysis in the Assessment of Diagnostic Imaging Technologies
Radiology, May 1, 2005; 235(2): 361 - 370.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
S. A. Lorch, A. Cnaan, and K. Barnhart
Cost-Effectiveness of Inhaled Nitric Oxide for the Management of Persistent Pulmonary Hypertension of the Newborn
Pediatrics, August 1, 2004; 114(2): 417 - 426.
[Abstract] [Full Text] [PDF]

Home page
 J Natl Cancer Inst MonogrHome page
S. J. Goldie
Chapter 15: Public Health Policy and Cost-Effectiveness Analysis
J Natl Cancer Inst Monographs, June 1, 2003; 2003(31): 102 - 110.
[Abstract] [Full Text] [PDF]