Biomedical subjects

P Wakker

Publications and source records attributed to P Wakker.

3 recordsLinked to original sources

PubMedDate not supplied

Confidence intervals for cost/effectiveness ratios.

The reduction of costs is becoming increasingly important in the medical field. The relevant topic of many clinical trials is not effectiveness per se, but rather cost-effectiveness ratios. Surprisingly, no statistical tools for analyzing cost-effectiveness ratios have been provided in the medical literature yet. This paper explains the gap in the literature, and provides a first technique for obtaining confidence intervals for cost-effectiveness ratios. The technique does not use sophisticated tools to achieve maximal optimality, but seeks for tractability and ease of application while still satisfying all formal statistical requirements.

Clinical Trials as Topic↗

PubMedDate not supplied

Explaining distortions in utility elicitation through the rank-dependent model for risky choices.

The standard-gamble (SG) method has been accepted as the "gold standard" for the elicitation of utility when risk or uncertainty is involved in decisions, and thus for the measurement of utility in medical decisions. It is based on the assumptions of expected-utility theory. Unfortunately, there is now abundant evidence that expected utility is not empirically valid, and that the SG method overestimates risk aversion and the utilities of impaired health states. This paper shows how rank-dependent utility theory, a newly developed theory in decision science, can explain the main violations of expected utility. Thus it provides a means for correcting the SG method and for improving the assessments of quality-adjusted life years for medical decisions in which there is uncertainty about outcomes.

Bias↗

PubMedDate not supplied

A criticism of healthy-years equivalents.

The following questions describe the scope of this paper. When decision trees are used to analyze optimal decisions, should end nodes be evaluated on the basis of QALYs or on the basis of healthy-years equivalents? Which measures should be used in communications with others, e.g., patients? Which of these measures incorporate risk attitudes, and which do not? It is demonstrated that the healthy-years equivalent measure does not stand scrunity.

Communication↗