Format

Send to

Choose Destination
See comment in PubMed Commons below
Value Health. 2010 Dec;13(8):1056-60. doi: 10.1111/j.1524-4733.2010.00775.x. Epub 2010 Sep 3.

Discrete event simulation: the preferred technique for health economic evaluations?

Author information

1
Department of Epidemiology, Biostatistics and Occupational Health, Division of General Internal Medicine, McGill University, Montreal, QC, Canada. jaime.caro@mcgill.ca

Abstract

OBJECTIVES:

To argue that discrete event simulation should be preferred to cohort Markov models for economic evaluations in health care.

METHODS:

The basis for the modeling techniques is reviewed. For many health-care decisions, existing data are insufficient to fully inform them, necessitating the use of modeling to estimate the consequences that are relevant to decision-makers. These models must reflect what is known about the problem at a level of detail sufficient to inform the questions. Oversimplification will result in estimates that are not only inaccurate, but potentially misleading.

RESULTS:

Markov cohort models, though currently popular, have so many limitations and inherent assumptions that they are inadequate to inform most health-care decisions. An event-based individual simulation offers an alternative much better suited to the problem. A properly designed discrete event simulation provides more accurate, relevant estimates without being computationally prohibitive. It does require more data and may be a challenge to convey transparently, but these are necessary trade-offs to provide meaningful and valid results.

CONCLUSION:

In our opinion, discrete event simulation should be the preferred technique for health economic evaluations today.

[Indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center