…and, when used as a basis for decision modelling, helpful for decision makers in NICE technology appraisals
Dr Carole Longson
Appraisal Programme Director
Attributes of Technology Appraisal
• Independent advisory committee formulates guidance
• Transparent and inclusive process
• Consultation with diverse groups
• All groups invited to submit evidence
Attributes of Technology Appraisal• ‘Inclusive’ evidence base, not just
clinical trials
• Multiple perspectives are often conflicting
• Decisions are made in the ‘real world’lack of evidence or conflicting
evidenceconflicting views of the same evidenceuncertainty
The Appraisal Challenge•Balance the
evidence from different inputs
•Make robust decisions with less than perfect information
•Ensure process is transparent and decisions are justifiable
Independent technology assessment
Patients and carers views and preferences
Health professionals opinion
Modelling the Modelling the unknownunknown
Manufacturers data
Balancing the Evidence
Why we need decision analytic models
• Uncertainty is the norm in technology appraisal!
• Good models help decision makers deal with complex and sometimes conflicting evidence
Why we need decision analytic models?
• To model or not to model?Yes, no choice for many appraisals
• Decision analytic models help make better decisions at time t in the absence of perfect information This is just what the appraisal
process needs
Modelling Techniques and Decision Making
‘The good, the bad, the useful and the not so useful’
We get them all in technology appraisals
"There is nothing more difficult to plan, more doubtful of success, nor more dangerous to manage, than the creation of a new system.
For the initiator has the enmity of all who would profit by the preservation of the old institutions, and merely lukewarm defenders
in those who should gain by the new ones."MachiavellMachiavellii
The Appraisal ChallengeThe Appraisal ChallengeWhat have we learnt?What have we learnt?
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