{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:00:29Z","timestamp":1774620029034,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2003,11,14]],"date-time":"2003-11-14T00:00:00Z","timestamp":1068768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Statistics in Medicine"],"published-print":{"date-parts":[[2003,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Increasingly complex models are being used to evaluate the cost\u2010effectiveness of medical interventions. We describe the multiple sources of uncertainty that are relevant to such models, and their relation to either probabilistic or deterministic sensitivity analysis. A Bayesian approach appears natural in this context. We explore how sensitivity analysis to patient heterogeneity and parameter uncertainty can be simultaneously investigated, and illustrate the necessary computation when expected costs and benefits can be calculated in closed form, such as in discrete\u2010time discrete\u2010state Markov models. Information about parameters can either be expressed as a prior distribution, or derived as a posterior distribution given a generalized synthesis of available data in which multiple sources of evidence can be differentially weighted according to their assumed quality. The resulting joint posterior distributions on costs and benefits can then provide inferences on incremental cost\u2010effectiveness, best presented as posterior distributions over net\u2010benefit and cost\u2010effectiveness acceptability curves. These ideas are illustrated with a detailed running example concerning the cost\u2010effectiveness of hip prostheses in different age\u2013sex subgroups. All computations are carried out using freely available software for conducting Markov chain Monte Carlo analysis. Copyright 2003 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/sim.1586","type":"journal-article","created":{"date-parts":[[2003,12,2]],"date-time":"2003-12-02T14:35:45Z","timestamp":1070375745000},"page":"3687-3709","source":"Crossref","is-referenced-by-count":162,"title":["Bayesian approaches to multiple sources of evidence and uncertainty in complex cost\u2010effectiveness modelling"],"prefix":"10.1002","volume":"22","author":[{"given":"David J","family":"Spiegelhalter","sequence":"first","affiliation":[]},{"given":"Nicola G","family":"Best","sequence":"additional","affiliation":[]}],"member":"311","published-online":{"date-parts":[[2003,11,14]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200017050-00006"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462301104010"},{"key":"e_1_2_1_4_2","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1093\/oso\/9780195108248.003.0008","volume-title":"Cost Effectiveness in Health and Medicine","author":"Manning WG","year":"1996"},{"key":"e_1_2_1_5_2","unstructured":"SpiegelhalterDJ ThomasA BestNG LunnD. WinBUGS Version 1.4 User Manual. MRC Biostatistics Unit Cambridge available fromwww.mrc\u2010bsu.cam.ac.uk\/bugs2002."},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462301104095"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.319.7210.635"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/10807039609383655"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02015.x"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.314.7077.354a"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-199813040-00003"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19981115)17:21<2509::AID-SIM949>3.0.CO;2-V"},{"key":"e_1_2_1_13_2","unstructured":"NICE Appraisal Group. The effectiveness and cost effectiveness of different prostheses for primary total hip replacement. Technical Report http:\/\/www.nice.org.uk2000."},{"issue":"2","key":"e_1_2_1_14_2","first-page":"1","article-title":"Primary total hip replacement surgery: a systematic review of outcomes and modelling cost effectiveness associated with different prostheses","volume":"20","author":"Fitzpatrick R","year":"1998","journal-title":"Health Technology Assessment"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.53.9.542"},{"issue":"6","key":"e_1_2_1_16_2","first-page":"1","article-title":"Effectiveness of hip prostheses in primary total hip replacement: a critical review of evidence and an economic model","volume":"20","author":"Faulkner A","year":"1998","journal-title":"Health Technology Assessment"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453679308993679"},{"key":"e_1_2_1_18_2","unstructured":"MalchauH HerbertsP.Prognosis of total hip replacement: revision and re\u2010revision rate in thr. a revision\u2010risk study of 148 359 primary operations. In Proceedings of the 65th Annual Meeting of America Academy of Orthopaedic Surgeons New Orleans U.S.A. 1998."},{"key":"e_1_2_1_19_2","first-page":"1619","article-title":"The effect of elective total hip\u2010replacement on health\u2010related quality\u2010of\u2010life","volume":"75","author":"Laupacis A","year":"1993","journal-title":"Journal of Bone and Joint Surgery, American Volume"},{"key":"e_1_2_1_20_2","unstructured":"Palisade Europe. @RISK 4.0. Technical Report http:\/\/www.palisade\u2010europe.com2001."},{"key":"e_1_2_1_21_2","unstructured":"Decisioneering. Crystal Ball. Technical Report http:\/\/www.decisioneering.com\/crystal_ball2000."},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X0002000308"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200017040-00004"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/hec.617"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.861"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462301104083"},{"key":"e_1_2_1_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780142408"},{"key":"e_1_2_1_28_2","volume-title":"Methods for Meta\u2010Analysis in Medical Research","author":"Sutton A","year":"2000"},{"key":"e_1_2_1_29_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462300004694"},{"key":"e_1_2_1_30_2","volume-title":"Meta\u2010Analysis by the Confidence Profile Method: the Statistical Synthesis of Evidence","author":"Eddy DM","year":"1992"},{"key":"e_1_2_1_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0258(20001230)19:24<3359::AID-SIM710>3.0.CO;2-N"},{"key":"e_1_2_1_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19970830)16:16<1817::AID-SIM621>3.0.CO;2-N"},{"key":"e_1_2_1_33_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10473815"},{"key":"e_1_2_1_34_2","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1302\/0301-620X.78B2.0780178","article-title":"Stanmore compared with Charnley total hip replacement\u2014a prospective study of 413 arthroplasties","volume":"78","author":"Marston RA","year":"1996","journal-title":"Journal of Bone and Joint Surgery British Volume"},{"key":"e_1_2_1_35_2","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1302\/0301-620X.78B5.0780802","article-title":"Long\u2010term comparison of Charnley and Stanmore design total hip replacements","volume":"78","author":"Britton AR","year":"1996","journal-title":"Journal of Bone and Joint Surgery British Volume"},{"key":"e_1_2_1_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X9901900306"},{"key":"e_1_2_1_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980815\/30)17:15\/16<1715::AID-SIM973>3.0.CO;2-6"},{"key":"e_1_2_1_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1050(199905)8:3<191::AID-HEC409>3.0.CO;2-R"},{"key":"e_1_2_1_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/44.6.811"},{"key":"e_1_2_1_40_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462301104071"},{"key":"e_1_2_1_41_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1050(199905)8:3<269::AID-HEC425>3.0.CO;2-D"},{"key":"e_1_2_1_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19991215)18:23<3235::AID-SIM313>3.0.CO;2-6"},{"key":"e_1_2_1_43_2","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200017050-00005"}],"container-title":["Statistics in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fsim.1586","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/sim.1586","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T13:43:06Z","timestamp":1700228586000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/sim.1586"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,11,14]]},"references-count":42,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2003,12,15]]}},"alternative-id":["10.1002\/sim.1586"],"URL":"https:\/\/doi.org\/10.1002\/sim.1586","archive":["Portico"],"relation":{},"ISSN":["0277-6715","1097-0258"],"issn-type":[{"value":"0277-6715","type":"print"},{"value":"1097-0258","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,11,14]]}}}