HEDS is part of the School of Health and Related Research (ScHARR) at the University of Sheffield. We undertake research, teaching, training and consultancy on all aspects of health related decision science, with a particular emphasis on health economics, HTA and evidence synthesis.

Monday, 21 May 2018

Estimating an exchange rate between the EQ-5D-3L and ASCOT

Image of Dr Donna Rowen
Dr Donna Rowen
HEDS have published a new paper by Dr Katherine Stevens, Professor John Brazier and Dr Donna Rowen titled 'Estimating an exchange rate between the EQ-5D-3L and ASCOT'

Professor John Brazier said: "How do health and social care QALYs compare? Using preference-based mapping we found moving from ASCOT to EQ-5D-3L TTO value sets is a linear transformation with an intercept of −0.0488 and gradient of 0.978."

The paper has been published in European Journal of Health Economics


Friday, 18 May 2018

Website of the Month - Systematic Review Tool Box

The website is a compendium of tools that support the systematic review process across multiple domains. It is community-driven and allows users to search its web-based catalogue to help reviewers find appropriate tools based on how they provide support for the systematic review process. Users can perform a simple keyword search (i.e. Quick Search) to locate tools, or conduct a more advanced search which allows users to select various criteria to find specific types of tools and in turn submit new tools to the database. 

The website says that: "Systematic reviews are a time consuming, logistically challenging and labour intensive undertaking. These and other challenges have led to the development of various software tools to support the systematic review process."

Screenshot of Systematic Review Toolbox website
The Toolbox also offers other tools or support mechanisms (such as checklists, guidelines and reporting standards) can also be found.

The developer and editor of the Systematic Review Toolbox is Dr Chris Marshall.
Suggestions for new tools can be made here. If you would like a tool's information edited or have any other queries, you can contact Chris here.

Thursday, 17 May 2018

We are recruiting! Research Assistant & Masters Studentship in Health Economics and Decision Modelling

Image of vacancy neon sign
Image CC BY Graeme Maclean
HEDS are currently recruiting a Research Assistant & Masters Studentship in Health Economics and Decision Modelling. If you are interested in joining us, please click the link below that will take you to the application process.

Reference: UOS019218
Closing date: 08.06.2018

The supporting documentation can be viewed and the on-line application accessed via the following link:    https://tinyurl.com/ybeclvll  

Wednesday, 16 May 2018

April’s CEAs.....

Our quick search for CEA’s published in April uncovered 52 articles.   In the right-hand column of this blog is a CEA Archive, which includes our CEA search results by month.  Below are those in our areas of interest.
  • Barnett AH, Arnoldini S, Hunt B, Subramanian G, Hoxer CS. Switching from sitagliptin to liraglutide to manage patients with type 2 diabetes in the UK: A long-term cost-effectiveness analysis. Diabetes, obesity & metabolism. 2018.
  • Dawkins BR, Mirelman AJ, Asaria M, Johansson KA, Cookson RA. Distributional cost-effectiveness analysis in low- and middle-income countries: illustrative example of rotavirus vaccination in Ethiopia. Health policy and planning. 2018;33(3):456-63.
  • Henry N, Jovanovic J, Schlueter M, Kritikou P, Wilson K, Myren KJ. Cost-utility analysis of life-long prophylaxis with recombinant factor VIIIFc vs recombinant factor VIII for the management of severe hemophilia A in Sweden. Journal of medical economics. 2018;21(4):318-25.
  • Leurent B, Gomes M, Faria R, Morris S, Grieve R, Carpenter JR. Sensitivity Analysis for Not-at-Random Missing Data in Trial-Based Cost-Effectiveness Analysis: A Tutorial. PharmacoEconomics. 2018.
  • Vilsboll AW, Mouritsen JM, Jensen LP, Bodker N, Holst AW, Pennisi CP, et al. Cell-based therapy for the treatment of female stress urinary incontinence: an early cost-effectiveness analysis. Regenerative medicine. 2018;13(3):321-30.

Tuesday, 15 May 2018

New Project - SYNTAX PROJECT: Integrated evidence synthesis for joint appraisal of tobacco and alcohol tax interventions for harm reduction in the UK

SYNTAX PROJECT: Integrated evidence synthesis for joint appraisal of tobacco and alcohol tax interventions for harm reduction in the UK

Universities of Sheffield and Bath, 2018-2021 both part of the UK Centre for Tobacco and Alcohol Studies (UKCTAS)

Project Aim
During this 3-year project, funded by the NIHR Public Health Research Programme, we aim to investigate how tobacco and alcohol taxation can be changed to improve health for all. We will talk with consumers, policymakers and experts and use survey and sales data to look at how tobacco and alcohol tax can work together: to change consumer behaviour and health; to benefit disadvantaged communities; and reduce NHS costs at a time of limited budgets.

Image of cigarette and a hand
CC BY Kari Söderholm
One in five adults in the UK smokes and one in five adults drinks alcohol in hazardous or harmful ways. These ‘lifestyle factors’ are leading causes of preventable illness and death, including from heart disease and cancers. Over 80,000 people a year die earlier than they should from diseases caused by drinking or smoking. For those who smoke and drink alcohol, the risk of developing these preventable diseases is even greater. This preventable human loss is compounded by an annual cost to the NHS of over £6 billion.
There is evidence that people buy less cigarettes and alcoholic drinks when the price increases. Health advocates are therefore calling for higher taxes and changes to tax structures on alcohol and tobacco products to encourage people to quit smoking and reduce their drinking. However, it is not clear what effect this would have on tax revenues and the wider economy. There is uncertainty about the effects of tax increases on smokers and drinkers who are on a low income or unemployed. Consumers can change their behaviour in response to changes in prices (for example, by switching to cheaper or illegal products).
Uncertainty can also arise because tobacco and alcohol companies and retailers can alter prices to ensure some products stay affordable despite tax increases. The planned research will address these areas of complexity.
Design Methods

The project will involve:

1) A UK-focused rapid review of tobacco and alcohol tax policy options and interviews with taxation policymakers and experts that capture how they understand and prioritise options for tobacco and alcohol taxes.
2) Analysis of social patterns in spending on tobacco and alcohol products using data from the nationally representative Living Costs and Food Survey.
3) Analysis of how industry and consumers are likely to respond to tax changes using several years of data on retail prices and consumer spending.
4) A population forecast to estimate how tax options might differ in their effects on consumer spending, health and health inequalities, costs of ill-health to the NHS, the tax revenue to government and outcomes to the wider economy in terms of sickness absence from work.
Public Involvement and Dissemination
Three established public involvement panels will be involved in the research: smokers; general drinkers; and people recovering from alcohol dependence or their families. Findings will be communicated direct to these panels, to taxation policymakers and experts through policy briefings and meetings, and to other scientists via conferences and journal articles.
Upcoming Syntax Events - Stakeholder Interviews
As part of the project, in early summer 2018, Dr Jenny Hatchard of the University of Bath and Dr Penny Buykx of the University of Sheffield will be conducting interviews with stakeholders with knowledge of tobacco and alcohol tax policy.
Interviews will cover the following questions:
- What options are there for separate and joint tobacco and alcohol taxation for the UK?
- Which policy effects are the most important?
- What additional factors influence policy outcomes?
- How complete is the evidence base for each policy option?
The SYNTAX team will use these interviews to understand how tobacco and alcohol taxation changes take place, co-exist and interact. Findings will contribute to the SYNTAX project’s development of an effective tool for estimating how tax options might differ in their effects on: 1) consumer spending; 2) health and health inequalities; 3) costs of ill-health to the NHS; and 4) tax revenue to the Government.
Contact Details

Please get in touch if you would like to hear more about the project, or participate in the stakeholder interviews.  Email SYNTAX@sheffield.ac.uk

Project Coordinators

  • Prof Alan Brennan
  • Dr Duncan Gillespie
Stakeholder Interview Team

  • Dr Jenny Hatchard
  • Dr Penny Buykx
Others involved in the project

  • Anna Gilmore, Professor of Public Health, Department for Health, University of Bath
  • Petra Meier, Professor of Public Health, School of Health and Related Research, University of Sheffield
  • John Holmes, Senior Research Fellow, School of Health and Related Research, University of Sheffield, john.holmes@sheffield.ac.uk.
  • Colin Angus, Research Fellow, School of Health and Related Research, University of Sheffield, c.r.angus@sheffield.ac.uk.
  • Rosemary Hiscock, Research Associate, Department for Health, University of Bath, r.hiscock@bath.ac.uk
  • Robert Pryce, Research Associate, School of Health and Related Research, University of Sheffield, r.e.pryce@sheffield.ac.uk
Enquiries:  SYNTAX@sheffield.ac.uk

Monday, 14 May 2018

Dr Kate Ren to deliver talk at the Promoting Statistical Insight (PSI) Conference - 'Breaking Boundaries in Drug Development'

Image of Dr Kate Ren
Dr Kate Ren
Dr Kate Ren is to deliver talk at the Promoting Statistical Insight (PSI) Conference - Breaking Boundaries in Drug Development in Damrak, Amsterdam. Dr Ren's talk is titled: Evidence synthesis with limited studies: incorporating genuine prior information about between-study heterogeneity

Background: Meta-analyses using fixed effect and random effects models are commonly applied to synthesise evidence from randomised controlled trials in health technology assessment. The models differ in their assumptions and the interpretation of the results. Fixed effect models are often used because there are too few studies with which to estimate the between-study standard deviation from the data alone, but not that heterogeneity is unlikely to be expected.

Objectives: The aim is to propose a framework for eliciting an informative prior distribution for the between-study standard deviation in a Bayesian random effects meta-analysis model to genuinely represent heterogeneity when data are sparse.

Methods: We developed an elicitation method using external information such as empirical evidence and experts’ beliefs on the ‘range’ of treatment effects in order to infer the prior distribution for the between-study standard deviation. We also developed the method to be implemented in R.

Results: The three-stage elicitation approach allows uncertainty to be represented by a genuine prior distribution to avoid making misleading inferences. It is flexible to what judgments an expert can provide, and is applicable to all common types of outcome measure.

Conclusions: The choice between using a fixed effect or random effects meta-analysis model depends on the inferences required and not on the number of available studies. Our elicitation framework captures external evidence about heterogeneity and overcomes the often implausible assumption that studies are estimating the same treatment effect, thereby improving the quality of inferences in decision making. 

The conference is between 3-6 June and registration is now open. To register please click here

Sessions will include data transparency, the Asterix project in rare diseases, application and implementation of methodologies in statistics, missing data, study design role play, regulatory town hall and many more, with speakers from industry, academia and regulatory agencies. View the online draft scientific programme here.

Thursday, 10 May 2018

Latest Publications from HEDS in April

Another bumper month of publications from HEDS in collaboration with colleagues in ScHARR and farther afield. Many of these are currently in press, so you can find much of our work in its open access form via our institutional repository. You can see all of our open access outputs here.

Image of British Medical Bulletin Journal
© Oxford University Press  
       Barbieri, M., Richardson, G., & Paisley, S. (2018). The cost-effectiveness of follow-up strategies after cancer treatment: a systematic literature review. British Medical Bulletin. http://doi.org/10.1093/bmb/ldy011

      Campbell, F., Booth, A., Hackett, S., & Sutton, A. (n.d.). Young people who display harmful sexual behaviors and their families. A qualitative systematic review of their experiences of professional interventions. Trauma, Violence, & Abuse.

      Chai, J. H., Lee, C. K., Lee, H. K., Wong, N., Teo, K., Tan, C. S., … Yoong, J. (2018). Cost-benefit analysis of introducing next-generation sequencing (metagenomic) pathogen testing in the setting of pyrexia of unknown origin. PLoS ONE, 13(4). http://doi.org/10.1371/journal.pone.0194648

Image of Quality of Life Journal
                                           © Springer
Connell, J., Carlton, J., Grundy, A., Taylor Buck, E., Keetharuth, A. D., Ricketts, T., … Brazier, J. (2018). The importance of content 
and face validity in instrument development: lessons learnt from 
service users when developing the Recovering Quality of Life 
measure (ReQoL). Quality of Life Research, 1–10. http://doi.org/10.1007/s11136-018-1847-y

Mulhern, B., Feng, Y., Shah, K., Janssen, M. F., Herdman, M., van Hout, B., & Devlin, N. (2018). Correction to: Comparing the UK EQ-5D-3L and English EQ-5D-5L Value Sets. PharmacoEconomics, 1. 

Penn, L., Rodrigues, A., Haste, A., Marques, M. M., Budig, K., Sainsbury, K., … Sniehotta, F. F. (2018). NHS Diabetes Prevention Programme in England: formative evaluation of the programme in early phase implementation. BMJ Open, 8(2), e019467. http://doi.org/10.1136/bmjopen-2017-019467

Image of BMJ Open Logo
          Pollard, D. J., Brennan, A., Dixon, S., Waugh, N., Elliott, J., Heller, S., … White, D. (2018). Cost-effectiveness of insulin pumps compared with multiple daily injections both provided with structured education for adults with type 1 diabetes: a health economic analysis of the Relative Effectiveness of Pumps over Structured Education (REPOSE) randomised controlled trial. BMJ Open, 8(4). http://doi.org/10.1136/bmjopen-2017-016766

        Preston, L. R., Chambers, D., Campbell, F., Cantrell, A., Turner, J., & Goyder, E. C. (2018). What evidence is there for the identification and management of frail older people in the emergency department? A systematic mapping review. Health Services and Delivery Research, 6(16). http://doi.org/10.3310/hsdr06160

Ren, S., Oakley, J. E., & Stevens, J. W. (2018, March 1). Incorporating Genuine Prior Information about Between-Study Heterogeneity in Random Effects Pairwise and Network Meta-Analyses. Medical Decision Making. http://doi.org/10.1177/0272989X18759488

Image of Value in Health Journal
                                          © ISPOR
Rowen, D. L., Mulhern, B., Stevens, K., & Vermaire, E. (n.d.). Estimating a Dutch value set for the paediatric preference-based CHU-9D using a discrete choice experiment with duration. Value 
in Health.

Shah, K., Tsuchiya, A., & Wailoo, A. (2018). Valuing health at the end of life: A review of stated preference studies in the social sciences literature. Social Science & Medicine, 204, 39–50. http://doi.org/10.1016/j.socscimed.2018.03.010

Shrestha, A., Martin, C., Burton, M., Collins, K., Holmes, G., Ward, S., … Wyld, L. (2018). Comparison of quality of life of older women treated with surgery or primary endocrine therapy for early breast cancer: propensity score matched analysis of a large prospective multicentre cohort study. In EUROPEAN JOURNAL OF CANCER (Vol. 92, pp. S3–S4). Retrieved from http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000429103100003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=0bfafa3ff357b450f062b62b10c587b7
Image of PharmacoEconomics
© Adis

       Tsuchiya, A., Feng, Y., Karimi, M., Hole, A., & van Hout, B. A. (n.d.). An exploration of the non-iterative time trade off method to value health states. Health Economics.

       Whitehurst, D. G. T., Latimer, N. R., Kagan, A., Palmer, R., Simmons-Mackie, N., Charles Victor, J., & Hoch, J. S. (n.d.). Developing accessible, pictorial versions of health-related quality of life instruments suitable for economic evaluation: a report of preliminary studies conducted in Canada and the United Kingdom. PharmacoEconomics - Open.

Monday, 30 April 2018

Medtech Innovation Briefings (MIBs)…

… published since our last update in January are listed below.  The MIBs review relevant published evidence and the likely costs of new technologies. They are designed to be fast, flexible and responsive to the need for information on innovative technologies.  MIBs are commissioned by NHS England.  Further details are available here.
  • Curos disinfecting cap for needleless connectors
  • ColonFlag for identifying people at risk of colorectal cancer
  • Coban 2 for venous leg ulcers   
  • Reveal LINQ insertable cardiac monitor to detect atrial fibrillation after cryptogenic stroke   
  • EpiFix for chronic wounds   
  • Minimally invasive percutaneous nephrolitholapaxy medium (MIP-M) for removing kidney stones   
  • MammaTyper in vitro diagnostic test for determining breast cancer subtypes   
  • Point-of-care creatinine tests before contrast-enhanced imaging   
  • Plasma EGFR mutation tests for adults with locally advanced or metastatic non-small-cell lung cancer

Thursday, 26 April 2018

NICE say “yes” to cabozatinib and “erm” to vandetanib

Cabozantinib and vandetanib for treating unresectable locally advanced or metastatic medullary thyroid cancer was recently appraised by NICE.  Sheffield was the ERG for this appraisal with Paul Tappenden, Chris Carroll, Jean Hamilton, Eva Kaltenthaler and Ruth Wong undertaking the research.

NICE were unable to release any recommendations on vandetanib and so it was split into a separate appraisal [ID1415].  This appraisal is still ongoing.

Wednesday, 25 April 2018

New projects: New NICE topic - Sodium zirconium cyclosilicate for treating hyperkalaemia

ScHARR-TAG has been allocated the following STA topic:

Sodium zirconium cyclosilicate for treating hyperkalaemia