Speaker: Laura Bojke, University of York
Formal expert elicitation can provide valuable information to inform health care decisions. Particularly where evidence is missing, less well developed or less appropriate. Elicitation is the process of transforming the subjective and implicit knowledge of experts into their quantifiable expressions. There have been a limited number of applications of expert elicitation in health care decision making; this is despite the fact that elicitation constitutes a reasonably low cost source of evidence. This work attempts to summarise the available literature on expert elicitation, most of which is not in HTA, so as to outline the methods available. In addition their applicability to HTA is critiqued, given its distinguishing features. Following existing protocols for expert elicitation in other areas and based on their typical chronology, activities in elicitation can be divided in three stages: pre-elicitation, conduct and post-elicitation. There are multiple methods available for each of these stages and there are methodological uncertainties apparent given the distinguishing features of health care decision making. These include: the selection of experts and minimising any biases, the appropriate method to elicit uncertainty as opposed to variability, how to elicit complex parameters and how to synthesise experts’ beliefs. The choices available and complexities arising are here illustrated using two examples: a medical device (negative wound pressure) and a diagnostic test (Photo Acoustic Mammography). Finally a project recently funded by the MRC is detailed. This attempts to establish a reference protocol for the elicitation of experts' judgements to inform health care decision making. In doing so a number of the methodological uncertainties described will be explored using experimental designs.
Laura is based at the Centre for Health Economics at the University of York and is currently working on the Collaboration for Leadership in Applied Research and Care (CLAHRC) for Yorkshire and Humber as part of the Health Economics and Outcomes Measurement team. The program of work includes the use of economic evaluation across sectors, economic evaluation for local decision makers and the use of routine data for economic evaluation. Laura contributes to a range of short courses ran at CHE and leads the Assessing the Impact of Medical Technologies on Health module as part of the distance learning MSc in Economic Evaluation for Health Technology Assessment.
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