CEA that use RCTs lack external validity if the RCT and the target population differ according to patient and provider characteristics that modify relative cost-effectiveness. Our team leads NIHR-funded CEA where clinical investigators suggest the potential lack of external validity could stop them applying the results in practice. For example, CALORIES is a CEA of early parenteral versus early enteral nutrition support. Decision makers want to know which intervention is cost-effective in routine practice, but in the RCT emergency admissions are underrepresented.
Our focus is on:
- Developing a conceptual framework that defines the assumptions required to estimate incremental cost-effectiveness for the target population from RCT data.
KEY PEOPLE: Richard Grieve