|
Use the knowledge you
have gained from this chapter to see if you can identify the best
solutions for the four case studies that follow.
Problem
12.1
You are
conducting a trial of a new clinical reminder system that will
be delivered to your entire health care system through the electronic
patient medical record. The reminders cover multiple interventions,
including both preventive medicine and chronic disease management.
You want to select a measure of overall health status that can
be self-administered by large numbers of patients. You do not
plan to do decision modeling or cost-effectiveness analysis.
Question
12.1
Which of the following
measures would be most suitable?
Problem
12.2
You are planning a
study of a new treatment for mild osteoarthritis and you want
to use a measure that will allow you to do a cost-effectiveness
analysis if the intervention proves to be effective. You anticipate
that, for some patients, mild arthritis will be such a minor problem
that it will not represent much disutility, so you want to have
a measure that will allow you to detect small changes in utility.
Question
12.2
Which measure would
you select?
Problem
12.3
You are
a planner for a large national health plan or government health
agency. You are planning a study in which you will compare several
different programs to be implemented across the health care system.
You would like to assess the cost-effectiveness of each program
to contribute to the decision of which one to implement. As recommended
by the Panel on Cost Effectiveness in Health and Medicine (Gold,
Siegel et al., 1996), you want to use societal values in your
analysis. You want to obtain measures of health-related quality
of life from many of the program participants, but you need a
measure that can be administered quickly and easily by a mailed
survey.
Question
12.3
Which
measure would you select?
Problem
12.4
You are planning a
cost-effectiveness-analysis for a 12-month randomized clinical
trial of a geriatric management program for frail elders. The
trial has ended and has shown that the program was effective.
During the trial, no utilities were assessed from participants;
however, detailed information was obtained from the study participants
about functional health status as measured by activities of daily
living (ADLs). You would like to map the ADL health states of
the subjects in the study to a measure that you can use in cost-effectiveness
analysis.
Question
12.4
Assuming that each
of the following was available, which would you choose?
|