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Multivariate generalised linear mixed-effects models for the analysis of clinical trial-based cost-effectiveness data
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Achana, Felix A., Gallacher, Daniel C., Oppong, Raymond, Kim, Sungwook, Petrou, Stavros, Mason, James and Crowther, Michael (2021) Multivariate generalised linear mixed-effects models for the analysis of clinical trial-based cost-effectiveness data. Medical Decision Making, 41 (6). pp. 667-684. doi:10.1177/0272989X211003880
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Official URL: https://doi.org/10.1177/0272989X211003880
Abstract
Economic evaluations conducted alongside randomized controlled trials are a popular vehicle for generating high-quality evidence on the incremental cost-effectiveness of competing health care interventions. Typically, in these studies, resource use (and by extension, economic costs) and clinical (or preference-based health) outcomes data are collected prospectively for trial participants to estimate the joint distribution of incremental costs and incremental benefits associated with the intervention. In this article, we extend the generalized linear mixed-model framework to enable simultaneous modeling of multiple outcomes of mixed data types, such as those typically encountered in trial-based economic evaluations, taking into account correlation of outcomes due to repeated measurements on the same individual and other clustering effects. We provide new wrapper functions to estimate the models in Stata and R by maximum and restricted maximum quasi-likelihood and compare the performance of the new routines with alternative implementations across a range of statistical programming packages. Empirical applications using observed and simulated data from clinical trials suggest that the new methods produce broadly similar results as compared with Stata’s merlin and gsem commands and a Bayesian implementation in WinBUGS. We highlight that, although these empirical applications primarily focus on trial-based economic evaluations, the new methods presented can be generalized to other health economic investigations characterized by multivariate hierarchical data structures.
| Item Type: | Journal Article | |||||||||
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| Subjects: | R Medicine > RC Internal medicine | |||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School | |||||||||
| Library of Congress Subject Headings (LCSH): | Clinical trials, Clinical trials -- Cost effectiveness | |||||||||
| Journal or Publication Title: | Medical Decision Making | |||||||||
| Publisher: | Sage Publications, Inc. | |||||||||
| ISSN: | 0272-989X | |||||||||
| Official Date: | 1 August 2021 | |||||||||
| Dates: |
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| Volume: | 41 | |||||||||
| Number: | 6 | |||||||||
| Page Range: | pp. 667-684 | |||||||||
| DOI: | 10.1177/0272989X211003880 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Access rights to Published version: | Open Access | |||||||||
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