Multivariate Generalized Linear Mixed-Effects Models for the Analysis of Clinical Trial-Based Cost-Effectiveness Data.

Content Provider	Europe PMC
Author	Achana, Felix Gallacher, Daniel Oppong, Raymond Kim, Sungwook Petrou, Stavros Mason, James Crowther, Michael
Copyright Year	2021
Abstract	Economic evaluations conducted alongside randomized controlled trials are a popular vehicle for generating high-quality evidence on the incremental cost-effectiveness of competing health care interventions. Typically, in these studies, resource use (and by extension, economic costs) and clinical (or preference-based health) outcomes data are collected prospectively for trial participants to estimate the joint distribution of incremental costs and incremental benefits associated with the intervention. In this article, we extend the generalized linear mixed-model framework to enable simultaneous modeling of multiple outcomes of mixed data types, such as those typically encountered in trial-based economic evaluations, taking into account correlation of outcomes due to repeated measurements on the same individual and other clustering effects. We provide new wrapper functions to estimate the models in Stata and R by maximum and restricted maximum quasi-likelihood and compare the performance of the new routines with alternative implementations across a range of statistical programming packages. Empirical applications using observed and simulated data from clinical trials suggest that the new methods produce broadly similar results as compared with Stata’s merlin and gsem commands and a Bayesian implementation in WinBUGS. We highlight that, although these empirical applications primarily focus on trial-based economic evaluations, the new methods presented can be generalized to other health economic investigations characterized by multivariate hierarchical data structures.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8295965&blobtype=pdf
ISSN	0272989X
Journal	Medical Decision Making [Med Decis Making]
Volume Number	41
PubMed Central reference number	PMC8295965
Issue Number	6
PubMed reference number	33813933
e-ISSN	1552681X
DOI	10.1177/0272989x211003880
Language	English
Publisher	SAGE Publications
Publisher Date	2021-04-05
Publisher Place	Sage CA: Los Angeles, CA
Access Restriction	Open
Rights License	This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). © The Author(s) 2021
Subject Keyword	cluster randomised controlled trials cost-effectiveness analysis economic evaluation alongside randomised controlled trials multicentre and multinational randomised controlled trials
Content Type	Text
Resource Type	Article
Subject	Health Policy