Evidence map›Paper›PMID 32389221›Full record

ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2020

Addressing Challenges of Economic Evaluation in Precision Medicine Using Dynamic Simulation Modeling.

Deborah A Marshall, Luiza R Grazziotin, Dean A Regier, Sarah Wordsworth, James Buchanan, Kathryn Phillips, Maarten Ijzerman

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 7 pooled it
9.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 7 syntheses or guidelines pooled it, 53 citations in OpenAlex.

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  12. Meta-Modeling as a Variance-Reduction Technique for Stochastic Model-Based Cost-Effectiveness Analyses.Medical decision making : an international journal of the Society for Medical Decision Making · 2025
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  14. How is Value Defined in Molecular Testing in Cancer? A Scoping Review.Applied health economics and health policy · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 5 countries.

Deborah A MarshallDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada. Electronic address: damarsha@ucalgary.ca.
Luiza R GrazziotinDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.
Dean A RegierAlberta Cancer Control Research, BC Cancer, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Sarah WordsworthHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, England, UK; National Institute for Health Research Oxford Biomedical Research Centre, Oxford, England, UK.
James BuchananHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, England, UK; National Institute for Health Research Oxford Biomedical Research Centre, Oxford, England, UK.
Kathryn PhillipsCenter for Translational & Policy Research on Personalized Medicine, Department of Clinical Pharmacy, University of California San Francisco, San Francisco, CA, USA; Philip R. Lee Institute for Health Policy, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California at San Franciso, San Francisco, CA, USA.
Maarten IjzermanDepartment of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands; Cancer Health Services Research, University of Melbourne Centre for Cancer Research, School of Population and Global Health, Melbourne, Australia.
National Institute for Health Research · GBUniversity of Calgary · CALee University · USThe University of Melbourne · AUUniversity of British Columbia · CA

Funding

NCI NIH HHS R01 CA221870NHGRI NIH HHS U01 HG009599
6 · The paper itself

Abstract

objectivesThe objective of this article is to describe the unique challenges and present potential solutions and approaches for economic evaluations of precision medicine (PM) interventions using simulation modeling methods.

methodsGiven the large and growing number of PM interventions and applications, methods are needed for economic evaluation of PM that can handle the complexity of cascading decisions and patient-specific heterogeneity reflected in the myriad testing and treatment pathways. Traditional approaches (eg, Markov models) have limitations, and other modeling techniques may be required to overcome these challenges. Dynamic simulation models, such as discrete event simulation and agent-based models, are used to design and develop mathematical representations of complex systems and intervention scenarios to evaluate the consequence of interventions over time from a systems perspective.

resultsSome of the methodological challenges of modeling PM can be addressed using dynamic simulation models. For example, issues regarding companion diagnostics, combining and sequencing of tests, and diagnostic performance of tests can be addressed by capturing patient-specific pathways in the context of care delivery. Issues regarding patient heterogeneity can be addressed by using patient-level simulation models.

conclusionThe economic evaluation of PM interventions poses unique methodological challenges that might require new solutions. Simulation models are well suited for economic evaluation in PM because they enable patient-level analyses and can capture the dynamics of interventions in complex systems specific to the context of healthcare service delivery.

Indexed as

Computer SimulationCost-Benefit AnalysisPrecision MedicineDelivery of Health CareHumanseconomic evaluationprecision medicinesimulation model

Identifiers

PMID32389221
PMCPMC7218800
OpenAlexW3013595319

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.