[Modeling in value-based medicine].
Modeling plays an important role in value-based medicine (VBM). It allows decision support by predicting potential clinical and economic consequences, frequently combining different sources of evidence. Based on relevant publications and examples focusing on ophthalmology the key economic modeling methods are explained and definitions are given. The most frequently applied model types are decision trees, Markov models, and discrete event simulation (DES) models. Model validation includes besides verifying internal validity comparison with other models (external validity) and ideally validation of its predictive properties. The existing uncertainty with any modeling should be clearly stated. This is true for economic modeling in VBM as well as when using disease risk models to support clinical decisions. In economic modeling uni- and multivariate sensitivity analyses are usually applied; the key concepts here are tornado plots and cost-effectiveness acceptability curves. Given the existing uncertainty, modeling helps to make better informed decisions than without this additional information.
Neubauer
A S
AS
Augenklinik der Ludwig-Maximilians-Universität, München, Deutschland. Aljoscha.Neubauer@med.uni-muenchen.de
Hirneiss
C
C
Kampik
A
A
D003362:Cost-Benefit Analysis / Q000191:economics; D019317:Evidence-Based Medicine / Q000191:economics; D005858:Germany; D017059:Models, Econometric; D009313:National Health Programs / Q000191:economics*; D009885:Ophthalmology / Q000191:economics*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015895:Relative Value Scales; D015203:Reproducibility of Results