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Gaceta Sanitaria

Print version ISSN 0213-9111


ARROSPIDE, Arantzazu; RAMOS-GONI, Juan Manuel; PECHLIVANOGLOU, Petros  and  MAR, Javier. Application of two-part models and Cholesky decomposition to incorporate covariate-adjusted utilities in probabilistic cost-effectiveness models. Gac Sanit [online]. 2020, vol.34, n.1, pp.91-95.  Epub May 18, 2020. ISSN 0213-9111.

This study aimed to explain a joint statistical procedure (two-part models and Cholesky decomposition) to incorporate second-order uncertainty from covariate adjusted mean utility functions in probabilistic costeffectiveness models. First, two-part models were applied to obtain parameters for the utility function. Second, a new set of correlated parameters for each simulation was obtained by Cholesky decomposition. The procedure was applied to EuroQol5D-5L in the Spanish Health Survey (21,007 adults). An example for the first simulation showed that 71% of men aged 60 years, high social status and normal weight were in perfect health, and in those not in perfect health, the expected utility was 0.8474 (= 1 -0.1526). Therefore, their estimated mean utility value was 0.9559. Mean utility values in the interval (-∞1] were calculated and their associated uncertainty incorporated in the cost-effectiveness models, based on the uncertainty related to correlated parameters in the utilities function.

Keywords : Uncertainty; Cost-utility analysis; Decision modelling; Health-related quality of life; Patient reported outcomes; Health survey.

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