PMID: 9551284Apr 29, 1998Paper

The cost-benefit of a randomized trial to a health care organization

Controlled Clinical Trials
J Hornberger, P Eghtesady

Abstract

Clinicians and patients make many decisions in situations where optimal treatment is uncertain. Despite well-published advantages of clinical trials for reducing such uncertainties, a trial may not be conducted because the sample size indicated by classical, hypothesis-testing methods is so large that no one institution could afford to sponsor the trial. By explicitly taking into consideration the costs and benefits of a trial, Bayesian statistical methods permit estimation of the value to a health care organization conducting a randomized trial instead of continuing to treat patients in the absence of more information. This paper describes a method for calculating the cost-benefit to a health care organization conducting a clinical trial, and the expected sample size to adequately resolve the uncertainties about which treatment is better. The method is illustrated in the case of a proposed clinical trial of a drug to prevent multiorgan system failure and death in patients admitted to the Stanford University surgical intensive care unit. This method should permit health care organizations to evaluate a proposed trial's expected cost-benefit and the expected sample size that will resolve the question of interest, and thereby ass...Continue Reading

References

Apr 1, 1989·Medical Decision Making : an International Journal of the Society for Medical Decision Making·A Mehrez, A Gafni
Oct 6, 1989·JAMA : the Journal of the American Medical Association·A S Detsky
Feb 9, 1989·The New England Journal of Medicine·S J Weiss
Dec 1, 1989·Controlled Clinical Trials·L S Freedman, D J Spiegelhalter
Feb 1, 1986·Archives of Surgery·C J CarricoR V Maier
Oct 1, 1987·Annals of Internal Medicine·W M TierneyM P Rogers
Oct 24, 1986·Science·K J TraceyJ D Albert
Feb 1, 1995·Critical Care Medicine·J C PreiserJ L Vincent
Sep 1, 1995·The British Journal of Surgery·B Theis
Apr 1, 1995·The British Journal of Surgery·G J McLauchlanK C Fearon
Aug 1, 1993·Statistics in Medicine·J Whitehead
Jan 1, 1993·Statistical Methods in Medical Research·T C Chalmers, J Lau
Oct 30, 1995·Statistics in Medicine·J C HornbergerJ Halpern
May 1, 1996·American Journal of Public Health·M O FinkelsteinH Robbins
May 1, 1996·American Journal of Public Health·M O FinkelsteinH Robbins
Dec 9, 1994·Clinical Intensive Care : International Journal of Critical & Coronary Care Medicine·A BoillotF Barale
Feb 9, 1986·Journal of Health Economics·G W Torrance

❮ Previous
Next ❯

Citations

Mar 17, 2001·Statistics in Medicine·J HalpernJ Hornberger
Jul 6, 2001·Statistics in Medicine·K H Zou, S L Normand
Sep 18, 2001·Journal of Health Economics·K Claxton, K M Thompson
Jan 6, 2009·Critical Care Medicine·Michael C Reade, Derek C Angus
Oct 13, 2011·PharmacoEconomics·Andrew R Willan
May 18, 2012·PharmacoEconomics·Andrew R Willan, Simon Eckermann
Jul 18, 2014·Journal of General Internal Medicine·Lusine AbrahamyanUNKNOWN Canadian Hemophilia Primary Prophylaxis (CHPS) Study Group
Sep 25, 2015·Expert Review of Pharmacoeconomics & Outcomes Research·Lazaros Andronis
Apr 5, 2005·Statistics in Medicine·Andrew R Willan, Eleanor M Pinto
Apr 29, 2009·Health Economics·Andrew R Willan, Simon Eckermann
Apr 26, 2008·Health Economics·Simon Eckermann, Andrew R Willan
Jan 10, 2014·Statistics in Medicine·Maggie Hong Chen, Andrew R Willan
Dec 25, 2012·Clinical Trials : Journal of the Society for Clinical Trials·Maggie H Chen, Andrew R Willan
Jun 7, 2015·Statistical Methods in Medical Research·Siew Wan HeeNigel Stallard
Jan 19, 2000·Medical Decision Making : an International Journal of the Society for Medical Decision Making·J Hornberger, M K Goldstein
May 20, 2015·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Joanna ThornLazaros Andronis
May 25, 2004·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Fumie Yokota, Kimberly M Thompson
Nov 26, 2008·Clinical Trials : Journal of the Society for Clinical Trials·Andrew R Willan
Aug 14, 2008·Clinical Trials : Journal of the Society for Clinical Trials·Andrew Willan, Matthew Kowgier
Aug 24, 2007·Clinical Trials : Journal of the Society for Clinical Trials·Andrew R Willan
Nov 27, 1999·Journal of Biopharmaceutical Statistics·B JohnsonJ S Hodges
Feb 15, 2021·The Medical Journal of Australia·UNKNOWN joint ACTA/ACSQHC Working Group

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.