Review of guidelines for good practice in decision-analytic modelling in health technology assessment

BACKGROUND: Decision-analytic models represent an explicit way to synthesise evidence currently available on the outcomes and costs of alternative (mutually exclusive) healthcare interventions. Usually their objective is to obtain a clear understanding of the relationship between incremental cost and effect in order to assess relative cost-effectiveness and to determine which interventions should be adopted given existing information. Given that the use of decision-analytic modelling for health technology assessment has increased exponentially in recent years, there is a need to consider how good practice in the field has been defined. Since the 1980s, several published guidelines have been available for those developing and evaluating decision-analytic models for health technology assessment. However, given the speed at which economic evaluation methodology has progressed, it is timely to review, critically appraise and consolidate those existing guidelines on the use of decision-analytic modelling in health technology assessment, and to identify key issues where guidance is lacking. OBJECTIVES: To identify existing guidelines and develop a synthesised guideline plus accompanying checklist. In addition to provide guidance on key theoretical, methodological and practical issues and consider the implications of this research for what might be expected of future decision-analytic models