Abstract
Evaluating the incremental cost-effectiveness of a technology is critical to understanding the impact of its adoption. The purpose of this study was to evaluate, using a particular example, how the specific alternatives selected for a cost-effectiveness analysis may influence the results of the analysis. In this example, we analyzed the incremental cost-effectiveness of estriol screening for Down syndrome. Model assumptions of expected costs and effectiveness were based on previously published work involving four clinical strategies, including a 'do nothing' (no screening) strategy. When the analysis started with all four strategies, two of the strategies could not be considered cost- effective because of extended dominance. However, when we eliminated the 'do nothing' from the strategy set because of its clinical irrelevance, all three remaining strategies might be considered cost-effective from a policy perspective. We concluded that the incremental cost-effectiveness of clinical strategies could be strongly affected by the starting point for the analysis. Copyright (C) 1999 Elsevier Science Inc.
Original language | English (US) |
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Pages (from-to) | 517-522 |
Number of pages | 6 |
Journal | Journal of clinical epidemiology |
Volume | 52 |
Issue number | 6 |
DOIs | |
State | Published - Jun 1999 |
Keywords
- Alpha-fetoprotein
- Amniocentesis
- Cost-effectiveness analysis
- Extended dominance
- Prenatal diagnosis
ASJC Scopus subject areas
- Epidemiology