Book Description
Meta-analysis, decision analysis, and cost-effectiveness analysis are the cornerstones of evidence-based medicine. These related quantitative methods have become essential tools in the formulation of clinical and public policy based on the synthesis of evidence. All three methods are taught with increasing frequency in medical schools and schools of public health and in health policy courses at the undergraduate and graduate level. This book is a lucid introduction, and will serve the needs of students taking introductory courses that cover these topics. It will also be useful to clinicians and policymakers who need to understand the quantitative underpinnings of the methods in order to best apply the information that derives from them. The second edition of this popular book adds new material on cumulative meta-analysis as a method to explore heterogeneity. The coverage of cost-effectiveness analysis has been brought into close alignment with recommendations of the U.S. Public Health Panel on Cost-Effectiveness Analysis in Health and Medicine. Many of the examples have been replaced with more current examples, and all of the material has been updated to reflect recent advances in the methods and the emergence of consensus about some previously controversial issues. analysis. These three closely related methods have become even more important for synthesizing research since the first edition was published in 1994. And they have gained legitimacy as tools for guiding health policy.
Customer Reviews:
Best guide for analysis.......2006-12-20
There are several ways to do analysis of the health care industry but this book covers the big three. Cost Effectiveness is the most useful from a business standpoint. This book covers the math and theory behind each of these methods and gives strong arguments for how to write in each of them. As a health and pharmaceutical economist I found this book to be invaluable. It is written very clearly and helps sort through many of the issues especially meta analysis. If you are starting out in the health analyst field this is a must read and a book you will want to have handy at all times.
An excellent introductory text.......2002-02-05
Meta-analysis, as both an applied and theoretical science, continues to develop from its rather humble beginnings. Since most physicians lack a strong background in quantitative science, rigorous statistical approaches to clinical decision making have been slow to gain widespread support. Despite its limitations, meta-analysis is proving to be an important vehicle for making sense of the increasingly overwhelming amount of published data in the biomedical sciences. Petitti's book goes a long way in demystifying meta-analysis for the rank and file and also serves as an excellent introduction to the field for the more statistically literate.
Most of my own work is in meta-analysis and I bought the book exclusively for this content and not information on decision analysis and cost-effectiveness analysis. I do not mean to minimize the importance of the latter but rather point out my own narrow interest in the Petitti text.
The book is well written and concise. Petitti "cuts to the chase" explaining the theory underlying meta-analytic methods and provides many useful examples from the medical literature. The text is easy to follow, understandable and well balanced. A thorough reading should leave the reader well prepared for further exploration of applied meta-analysis as well as capable of articulating its strengths, weaknesses and future direction.
Overall, Petitti's text is an excellent place to start for those interested in learning the fundamentals of "research synthesis". The book is also an extremely handy references for the more experienced practitioner. I highly recommend it.
clearest yet description this topic.......1997-07-08
In a forest of mirky and arcane descriptions of a field that has come to dominate medical research and policy making, this book stands out for its clarity. Dr. Petitti speaks a language that normal people can understand. She avoids jargon and frequently uses quantitative examples that make it easy to plug in your own problems and directly apply her lessons to your tasks. This is easily the best book in print on this topic
Book Description
This highly successful textbook is now available in its third edition. Over the years it has become the standard textbook in the field world-wide. It mirrors the huge expansion of the field of economic evaluation in health care, since the last edition was published in 1997. This new edition builds on the strengths of previous editions, being clearly written in a style accessible to a wide readership. Key methodological principles are outlined using a critical appraisal checklist that can be applied to any published study. The methodological features of the basic forms of analysis are then explained in more detail with special emphasis of the latest views on productivity costs, the characterisation of uncertainty and the concept of net benefit. The book has been greatly revised and expanded especially concerning analysing patient-level data and decision-analytic modelling. There is discussion of new methodological approaches, including cost effectiveness acceptability curves, net benefit regression, probalistic sensitivity analysis and value of information analysis. There is an expanded chapter on the use of economic evaluation, including discussion of the use of cost-effectiveness thresholds, equity considerations and the transferability of economic data. This new edition is required reading for anyone commissioning, undertaking or using economic evaluations in health care, and will be popular with health service professionals, health economists, pharmacand health care decision makers. It is especially relevant for those taking pharmacoeconomics courses.
Customer Reviews:
Excellence for health economist.......2005-10-12
This book is excellent for health economists to initiate modern research design that use intermediate measurement to infer to longitudinal outcome. Anyway, it does not neglect the traditional methodology of health economics. Because of complicated methodology that is difficult to understand, there are not so enough the varied example to assist.
Average customer rating:
- Too many cooks (even if they are good ones) spoil the broth
- That's a good textbook for cost-effectiveness research in m
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Cost-Effectiveness in Health and Medicine
Manufacturer: Oxford University Press, USA
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Methods for the Economic Evaluation of Health Care Programmes
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Valuing Health Care: Costs, Benefits, and Effectiveness of Pharmaceuticals and Other Medical Technologies
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Designing and Conducting Cost-Effectiveness Analyses in Medicine and Health Care (Jossey-Bass Health Care Series)
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Meta-Analysis, Decision Analysis, and Cost-Effectiveness Analysis: Methods for Quantitative Synthesis in Medicine
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Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation
ASIN: 0195108248 |
Book Description
A unique, in-depth discussion of the uses and conduct of cost-effectiveness analyses (CEAs) as decision-making aids in the health and medical fields, this volume is the product of over two years of comprehensive research and deliberation by a multi-disciplinary panel of economists, ethicists, psychometricians, and clinicians. Exploring cost-effectiveness in the context of societal decision-making for resource allocation purposes, this volume proposes that analysts include a "reference-case" analysis in all CEAs designed to inform resource allocation and puts forth the most explicit set of guidelines (together with their rationale) ever defined on the conduct of CEAs. Important theoretical and practical issues encountered in measuring costs and effectiveness, evaluating outcomes, discounting, and dealing with uncertainty are examined in separate chapters. Additional chapters on framing and reporting of CEAs elucidate the purpose of the analysis and the effective communication of its findings. Cost-Effectiveness in Health and Medicine differs from the available literature in several key aspects. Most importantly, it represents a consensus on standard methods--a feature integral to a CEA, whose principal goal is to permit comparisons of the costs and health outcomes of alternative ways of improving health. The detailed level at which the discussion is offered is another major distinction of this book, since guidelines in journal literature and in CEA-related books tend to be rather general--to the extent that the analyst is left with little guidance on specific matters. The focused overview of the theoretical background underlying areas of controversy and of methodological alternatives, and, finally, the accessible writing style make this volume a top choice on the reading lists of analysts in medicine and public health who wish to improve practice and comparability of CEAs. The book will also appeal to decision-makers in government, managed care, and industry who wish to consider the uses and limitations of CEAs.
Customer Reviews:
Too many cooks (even if they are good ones) spoil the broth.......2006-02-24
This book pulls together a lot of information, but in my opinion it is written and organized very very poorly. I have over 10 yrs of experience in in the healthcare industry and came across this book during a grad level course in CEA.
Long, boring, convoluted sentences fill the pages of this book. It took about 3 times more time and effort to get through a page in this book compared to a page in respected journals like JAMA, NEJM, BMJ etc.
If you have lots of time and are doing research in this field - go for it. Alternatively if you want to quickly determine what CEA is about, I would recommend reading Peter Muennig and Kamran Khan "Designing and Conducting Cost-Effectiveness Analyses in Medicine and Health Care".
That's a good textbook for cost-effectiveness research in m.......2000-09-20
Recently, there is less book to approach the cost-effectiveness point in medicine . I think this book can give us the new concepts of this research.
Book Description
As public accountability has increased and resources have become scarcer, public health, like clinical medicine, has been forced to re-examine the benefits and costs of its activities. Decision and economic analysis are basic tools in carrying out that mission. These methods have become standard practice in clinical medicine and health services research. This book , now in its second edition, was written in an effort to apply and adapt that experience with public health situations. The book was originally written to introduce Centers for Disease Control and Prevention staff to the concepts of decision and economic analysis, to provide guidance on methods to maximize comparability of studios, and to provide access to frequently used reference information. It has been adapted to meet the needs of scientists and managers in state and local health departments and managed care organizations as well as students in schools of public health and clinicians for an introductory text --a text that shows how these methods can be applied in population-based practice, to facilitate better comparability of studies, and to solidify understanding of the scientific basis for use of these tools in decision making. Decision makers will learn how these studies are conducted so they can be critical consumers-- understanding the strengths and limitations- and apply findings to policy and practice. The second edition updates and expands upon the standard methodology for condcuting prevention effectiveness analyses. Each chapter has been revised or re-written. The chapters on measuring effectiveness, decision analysis, and making information useful for decision makers as well as several appendices are entirely new.
Customer Reviews:
Very helpful.......2002-04-29
This book was another one of Anne Haddix's greatests hits!
Book Description
The field of cost-effectiveness analysis has lacked an entry-level textbook until now. Designing and Conducting Cost-Effectiveness Analyses in Medicine and Health Care is a hands-on guide for conducting economic analyses that closely follows the recommendations of the Panel on Cost-Effectiveness in Health and Medicine. Step by step, Dr. Muennig outlines the theory and practice of cost-effectiveness and shows how to develop an original research question, retrieve data, design a decision analysis tree, calculate quality-adjusted life years, and test for error in analysis. The book provides clear and detailed instruction and includes a review of the epidemiological and biostatistical skills students need to conduct cost-effectiveness analyses. While the book is designed for students, it includes advanced topics for policymakers, community health experts, and preventive medicine residents who are interested in the field. The book uses a worked example to walk the reader through the process of designing and conducting an analysis and provides links to all of the major Internet-accessible sources of government data. This book will be a welcome addition to the library of students and seasoned researchers alike.
Customer Reviews:
good guided tour of cost-effectiveness analyses.......2002-03-25
This book was really well-written in that everything was laid out clearly and consistently. I could basically choose my level of involvement, since the author explicitly delineates what each chapter and each exercise is for. The book was especially helpful in helping me choose which statistical methods of analysis would best fit the data set and research question I was working on; no other books I looked up did this in a readable way. Also, what really impressed me is the fact that the book made all the exercises not only seem, but actually feel, easy (or at least logical), and it wasn't until the end that I realized that I had built a decent foundation in cost-effectiveness analysis. The lessons were cumulative, so that the process of doing the problem sets actually felt fulfilling.
Average customer rating:
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Valuing Health for Regulatory Cost-Effectiveness Analysis
Health, and Safety Regulation Committee to Evaluate Measures of Health Benefits for Environmental
Manufacturer: National Academies Press
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Is Prevention Better Than Cure? (Studies in Social Economics)
Louise B. Russell
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Educated Guesses: Making Policy about Medical Screening Tests
ASIN: 0815776322 |
Book Description
Medical research and practice is currently evolving from evidence-based medicine to an even higher quality of patient care: value-based medicine. Value-based medicine, which measures the patient's perceived value of health care interventions, allows a more accurate measure of the overall worth of interventions to a patient. Evidence-Based to Value-Based Medicine explains:
-The uses and practice of value-based medicine in today's healthcare environment
-How to integrate value-based medicine
-How to deliver a higher quality of clinical care
-How to measure and demonstrate the value of interventions to patients, policymakers and payers
-Innovative input variable methodologies
-A critical appraisal of health-related quality of life instruments
-An overview of healthcare economics
Book Description
Why is medical care in the United States so expensive? For decades, Americans have taken it as a matter of faith that we spend more because we have the best health care system in the world. But as costs levitate, that argument becomes more difficult to make. Today, we spend twice as much as Japan on health care—yet few would argue that our health care system is twice as good.
Instead, startling new evidence suggests that one out of every three of our health care dollars is squandered on unnecessary or redundant tests; unproven, sometimes unwanted procedures; and overpriced drugs and devices that, too often, are no better than the less expensive products they have replaced.
How did this happen? In Money-Driven Medicine, Maggie Mahar takes the reader behind the scenes of a $2 trillion industry to witness how billions of dollars are wasted in a Hobbesian marketplace that pits the industry's players against each other. In remarkably candid interviews, doctors, hospital administrators, patients, health care economists, corporate executives, and Wall Street analysts describe a war of "all against all" that can turn physicians, hospitals, insurers, drugmakers, and device makers into blood rivals. Rather than collaborating, doctors and hospitals compete. Rather than sharing knowledge, drugmakers and device makers divide value. Rather than thinking about long-term collective goals, the imperatives of an impatient marketplace force health care providers to focus on short-term fiscal imperatives. And so investments in untested bleeding-edge medical technologies crowd out investments in information technology that might, in the long run, not only reduce errors but contain costs.
In theory, free market competition should tame health care inflation. In fact, Mahar demonstrates, when it comes to medicine, the traditional laws of supply and demand do not apply. Normally, when supply expands, prices fall. But in the health care industry, as the number and variety of drugs, devices, and treatments multiplies, demand rises to absorb the excess, and prices climb. Meanwhile, the perverse incentives of a fee-for-service system reward health care providers for doing more, not less.
In this superbly written book, Mahar shows why doctors must take responsibility for the future of our health care industry. Today, she observes, "physicians have been stripped of their standing as professionals: Insurers address them as vendors ('Dear Health Care Provider'), drugmakers and device makers see them as customers (someone you might take to lunch or a strip club), while . . . consumers (aka patients) are encouraged to see their doctors as overpaid retailers. . . . Before patients can reclaim their rightful place as the center—and indeed as the raison d'être—of our health care system," Mahar suggests, "we must once again empower doctors . . . to practice patient-centered medicine—based not on corporate imperatives, doctors' druthers, or even patients' demands," but on the best scientific research available.
Customer Reviews:
amazing how much misinformation packed in 1 page.......2007-04-24
pragmatist - there is no single test that diagnoses the insult that kills you. An autopsy is an educated guess with the pathologist only having anatomical and histological information and limited physiological data. They have false positives, false negatives just like all the other clinicians. In the end, we all die regardless of what the pathologist labels us. When somebody has 20 medical problems and they die, it is shortsighted to think one problem killed them.
I have to come clean, I only read 1 paragraph on page 6, but that was already full of misinformation. Physicians _tried_ to lobby against the pharmaceutical company to prohibit their advertising. They did their best, but look at the result: Cialis and Viagra commercial every 2 minutes. This book is so wrong, they are not controlling the pharmaceutical industry.
I find it disgusting whenever people take data for proving their point. This author is obviously trying to cash in on the reader's sentiment of "American healthcare is bad," and possibly got your money. This book is not reviewed by a panel but just edited to make sure it is sensational enough to get your hard earned money.
I practice medicine, I am honest, and the day that I have to be dishonest to practice medicine I will do something else. I promise.
And Epi Stick med student sounds right.
More money spent doesn't always result in better outcomes.......2006-12-03
One can usually tell if a book is good by the passion it generates among its readers. Both good and bad. And this one is no exception!
This book challenges many of the myths about our healthcare system and presents a startling view of how broken the system really is.
Starting right at the beginning, the figures are 'mind numbing'- 2.2 trillion dollars spent each year and the breakdown of where the money comes from and how it is spent is sure to be a revelation to many.
Author Maggie Mahar has clearly done the research and presented a well written and clear, account of the healthcare system. Full of data yet nicely balanced with personal perspectives and stories.
For any serious student of the healthcare system, regardless of role within the system, even political persuasion, this book will help spread some light on where the money goes. With so much money 'slushing' around its easy to see how so many organisations make huge sums of money without delivering much value in return.
As a user of the healthcare system I'm disappointed by the failure of the system to deliver better health outcomes to consumers. This book certainly alerted me to my role in demanding better care and the need for me to take more responsiblity for my own health.
This is a very different book than Porter and Teisberg's 'Redefining Health Care'. Infintely more readable and compelling.
My one regret is the author did not confront the solution!
Misses the big targets - from a Med Student .......2006-12-03
Its the evil corporations! Its the HMOs! Medicine is broken! The world is ending, lets turn to our wonderful government, champion of handling disasters like Katrina.
I knew this book was a dud the moment she started taking about the "uninsured". Millions of people don't have healthcare - even millions of those that make upwards of $50,000. I wonder why that is? No, I don't wonder - its obvious to anyone who thinks about it for 15 seconds - sadly the author did not. Young healthy people don't get health coverage because they are making a rational assessment of risk. They may have catastrophic insurance - say something that covers trauma that has a $100,000 deductible. That's what rational people do - they save money if they don't need to spend it. And these people don't perceive a need for health coverage even though they can AFFORD it. I should have put the book down after the author had demonstrated such a lack of commonsense.
However I did not, so let me quote from the summary above. Its hard to take any author seriously that writes a thought that can be summed up as: "including the VA hospital system, which provides excellent care at modest cost thanks largely to its exemption from the pressures of competition". It does a fine job despite having no competition. Look everyone, the laws of economics that apply everywhere in the Universe have been suspended in Healthcare! Amazing. Whereas in every other industry the exact opposite happens? So odd.
This is another in a long string of books that tells people what they want to hear about American Healthcare.
So, why do HMOs exist? Why do we have businesses pay our health insurance (they don't pay our car insurance - odd)? The reason medicine is so messed up is because it is so regulated by the government. That's the bottom line. All the other players are simply making the best of the situation given the laws that our sage leaders have passed in their infinite economic wisdom (thats heavy sarcasm for those reading at home). I am always amused when the same government that completely broke the medical system by constant interference is heralded as its savior.
Let's think outside the box for once? Remove laws that urge corporations to provide healthcare, remove laws that support the HMO structure, and tone down the incredible interference. Lets tone down the lawsuits (try suing the VA- you will get a big surprise on one of the ways the VA saves money). Then what will see? The same thing we see in the long run in every industry - competition leads to better services at lower costs. Does this book have the guts to say that despite the authors supposed keen insight. No, its a total disappointment!
Or lets write books that pretend medicine is in wonder land where its eternally opposite day for economics.
From a Patient's Point of View.......2006-08-08
First, a full disclosure: Maggie Mahar and I started at the same university at the same time on the same career path--far away from the Medical School. Both of us changed careers, we lived on opposite coasts, and lost touch over the years. But that's not why I bought this book. I bought it because I've had some serious chronic illnesses to manage for the past ten years, I've had more contact with the American medical system than most people, and I'm always asking questions. Most are questions about my own care. But I'm interested in the larger questions too, and this book gives some interesting answers.
As patients go, I'm one of the luckier ones--I have comprehensive health insurance, and many great doctors and nurses giving me both excellent care and moral support. But I've also been baffled and frustrated at times by the indifference and inefficiencies of the larger system. And I've seen these at both for-profit and non-profit hospitals, includng top-rated ones.
It's a scandal that the United States has so many uninsured people, and it's good news that a few states like Vermont and Massachusetts (if not the federal government) are at last showing some leadership on the issue. Dedicated groups in other states (certainly in California) are pushing for solutions too. But health coverage is just the most visible part of the problem. The problem is that "money-driven medicine" has too many perverse incentives to work the way medicine (or markets) are supposed to work. This well-researched and readable book tells you exactly why in both economic and personal terms--and many of the best anecdotes and insights come from inside the system, especially from frustrated physicians.
Unless you think that you and your family members will never get sick, but all die peacefully in your sleep at the age of 101, you should read this book just to protect yourself from the downside of the medical markets. It's not even an anti-capitalist thing to do. (Investors are always looking for ne3w ways to protect themselves from the downside of financial markets, after all.)
As this book rightly points out, if you haven't gone to medical school--or even if you have--when you or a family member gets sick, you have to trust your doctor. (There's reliable and unreliable information on the Internet, but it can't replace a doctor's long training and experience.) But make doctors earn your trust.
This is my personal advice, but it's confirmed by the information in this book. Ask questions; ask for some evidence that a drug or treatment will work; find out what the potential side effects are and how to avoid or mitigate them. Medicine is imperfect, and good doctors will admit what they do and don't know. (I think that's the litmus test for a good doctor.) In some situations, there may not be any evidence that one treatment is better than another, but you need to know that too. Try not ask irritating questions; but if the doctor gets irritated too easily, this may not be the doctor for you.
I have absolutely no solutions to the larger puzzle of the whole system--and neither does this book. After reading it, though, I think that doctors, nurses and other health professionals need help from some quarter to do their difficult jobs without so much interference from market forces. Eisenhower warned about the downside of the military-industrial complex fifty years ago; and it's still with us, stronger than ever. Now Americans have a medical-industrial complex to cope with too, and it affects us in an even more intimate way.
Read "Market-Driven Medicine"-it's news you can use.
Money Driven Medicine.......2006-07-24
Essential read for anyone trying to understand the history and mystery of healthcare economic trends and market drivers. Having worked in the industry directly for over 15 years and being around it my entire life, this book is spot on! Absolutely calls it like it is.
Average customer rating:
- Excellent introduction to the problem
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Quality of Life and Pharmacoeconomics: An Introduction
Joyce A. Cramer , and
Bert Spilker
Manufacturer: Lippincott Williams & Wilkins
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Strategies in Pharmacoeconomics and Outcomes Research
ASIN: 0397518455 |
Book Description
Quality of Life and Pharmacoeconomics: An Introduction will familiarize students, clinicians, and researchers with the key principles and methods of quality of life and cost-effectiveness assessment in clinical trials. The book is based on abstracted material from the Second Edition of Dr. Spilker's definitive reference, Quality of Life and Pharmacoeconomics in Clinical Trials (1996). The material has been edited, condensed, and streamlined to provide a broad overview of approaches to quality of life assessment, evaluations of outcomes, and pharmacoeconomic methods. The integration of these three areas is one of the most valuable features of this introduction.Quality of Life and Pharmacoeconomics: An Introduction is divided into seven sections: introduction; social and psychological assessment; selected tests for quality of life assessment; reported methodology; special populations and specific diseases; utilities and outcomes; and pharmacoeconomics. Each section summarizes the crucial issues and provides selected references.
Customer Reviews:
Excellent introduction to the problem.......2000-06-22
This book (Quality of Life and Pharmacoeconomics : An Introduction) provides very valuable introduction into area of pharmacoeconomics, quality life meassurements and outcomes research. I supose, it is very suitable for students and first-time contact with the topic of future.
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