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The Confidence Profile Method: A Bayesian Method for Assessing Health Technologies

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  • David M. Eddy

    (Duke University, Durham, North Carolina)

Abstract

The Confidence Profile Method is a Bayesian method for adjusting and combining pieces of evidence to estimate parameters, such as the effect of health technologies on health outcomes. The information in each piece of evidence is captured in a likelihood function that gives the likelihood of the observed results of the evidence as a function of possible values of the parameter. A posterior distribution is calculated from Bayes formula as the product of the likelihood function and a prior distribution. Multiple pieces of evidence are incorporated by successive applications of Bayes' formula. Pieces of evidence are adjusted for biases to internal or external validity by modeling the biases and deriving “adjusted” likelihood functions that incorporate the models. Likelihood functions have been derived for one-, two- and multi-arm prospective studies; 2 × 2, 2 × n and matched case-control studies, and cross-sectional studies. Biases that can be incorporated in likelihood functions include crossover in controlled trials, error in measurement outcomes, patient selection biases, differences in technologies, and differences in length of follow-up. Effect measures include differences of rates, ratios of rates, and odds ratios. The elements of the method are illustrated with an analysis of the effect of a thrombolytic agent on the difference in probability of 1-year survival after a heart attack.

Suggested Citation

  • David M. Eddy, 1989. "The Confidence Profile Method: A Bayesian Method for Assessing Health Technologies," Operations Research, INFORMS, vol. 37(2), pages 210-228, April.
    • Handle: RePEc:inm:oropre:v:37:y:1989:i:2:p:210-228
    DOI: 10.1287/opre.37.2.210
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    Citations

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    Cited by:

    1. A. E. Ades & Karl Claxton & Mark Sculpher, 2006. "Evidence synthesis, parameter correlation and probabilistic sensitivity analysis," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 373-381, April.
    2. David M. Eddy & Vic Hasselblad & Ross Shachter, 1990. "An Introduction to a Bayesian Method for Meta-analysis," Medical Decision Making, , vol. 10(1), pages 15-23, February.
    3. Jeremy D. Goldhaber-Fiebert, 2012. "Accounting for Biases When Linking Empirical Studies and Simulation Models," Medical Decision Making, , vol. 32(3), pages 397-399, May.
    4. Woertman, Willem & Vermeulen, Bram & Groenewoud, Hans & van der Wilt, Gert Jan, 2013. "Evidence based policy decisions through a Bayesian approach: The case of a statin appraisal in the Netherlands," Health Policy, Elsevier, vol. 112(3), pages 234-240.
    5. Mehrez, A. & Yuan, Y. & Gafni, A., 1995. "The search for information -- A patient perspective on multiple opinions," European Journal of Operational Research, Elsevier, vol. 85(2), pages 244-262, September.
    6. A. E. Ades & G. Lu, 2003. "Correlations Between Parameters in Risk Models: Estimation and Propagation of Uncertainty by Markov Chain Monte Carlo," Risk Analysis, John Wiley & Sons, vol. 23(6), pages 1165-1172, December.
    7. K. M. Rhodes & J. Savović & R. Elbers & H. E. Jones & J. P. T. Higgins & J. A. C. Sterne & N. J. Welton & R. M. Turner, 2020. "Adjusting trial results for biases in meta‐analysis: combining data‐based evidence on bias with detailed trial assessment," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 183(1), pages 193-209, January.
    8. Newmark Armstrong, Georgina & Lairson, David R., 2006. "Cost-effectiveness of alternate contact protocols and costs of mammography promotion interventions for women veterans," Evaluation and Program Planning, Elsevier, vol. 29(2), pages 120-129, May.
    9. Vic Hasselblad & Douglas C. McCrory, 1995. "Meta-analytic Tools for Medical Decision Making: A Practical Guide," Medical Decision Making, , vol. 15(1), pages 81-96, February.
    10. A. E. Ades & S. Cliffe, 2002. "Markov Chain Monte Carlo Estimation of a Multiparameter Decision Model: Consistency of Evidence and the Accurate Assessment of Uncertainty," Medical Decision Making, , vol. 22(4), pages 359-371, August.
    11. Kevin P. Brand & Mitchell J. Small, 1995. "Updating Uncertainty in an Integrated Risk Assessment: Conceptual Framework and Methods," Risk Analysis, John Wiley & Sons, vol. 15(6), pages 719-729, December.

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