Hi,
I'm working on an economic analysis looking at clinical outcomes for uterine fibroid treatment. I was wondering if you could apply different cycle times to the same model, as I would like to add outcomes from complications and general side effects which are short-term (7 days to 1 month), and re-intervention rates which are longer term (every 6 months or yearly).
From what I've read, you must chose the shortest cycle time of what you'd like to observe. For example in my case, 7 days for general side-effects is the shortest time period to observe an outcome, so my cycle would be 7 days. However this is very short when applying other probabilities such as re-intervention rates and would take forever to do the analysis.
Is it possible to add short-term cycles to the same model somehow so that I can evaluate all these outcomes at once? I will be working with TreeAge Pro Healthcare if that helps!
Thanks!
Yes, in general it is possible to use different cycle lengths in a health economic model. You need to be careful, though e.g. with counting life years.
I have not worked with TreeAge in a while and I don't know if that software package allows for variable cycle length. If the manual does not mention how to handle this, then it seems quite unlikely that it is practically possible.
Best regards,
Rob
Thanks you! I will call the company to make sure. May I ask what program have you used in the past? I don't have much experience with coding so I wanted something user friendly!
For the kind of models that could be implemented in TreeAge, I generally use Excel. The resulting models are then considered to be more user friendly and transparent by my clients and offers e.g. better opportunities to present intermediate results. If you know what model implementation you want, then I think that TreeAge is not more developer friendly than Excel, possibly except for doing sensitivity analyses. If you see the latter as a problem, you may want to consider some add-in for that.
Hi Adnan, thanks for your answer! This seems like a good option, I'm just a little bit stuck on how to go about it.
I can add a decision node to start off, where my 4 different treatment strategies will branch off. A Markov node will then be added for each treatment strategy with 3 possible outcomes (death, treatment success, or treatment failure). How can I go back to a decision tree for the short-term events (complications) after I've already added a Markov node?
Additionally, is there any way I can add more than just these three health states further on in the model?
Thank you!! :)
Ok that makes sense!! Thank you this is really helpful :)
I'm wondering though, if I add the Markov nodes after the complications, will the final ICER calculations be calculated for each treatment strategy, or each treatment strategy depending on the short term events, since there's a Markov node after each subbranch of the complications.
For example, I posted a picture of the beginning of my tree, would it calculate the ICER for Hysterectomy + major comp + minor comp, and then compare it with hysterectomy +major comp + no minor comp and so on? Or would I be able to compare strictly hysterectomy with the other 4 treatment strategies following the decision node, which would include all the possibilities of complications?
Ok so if my health states start at the Markov node, after the cohort runs the first cycle, there is a chance that patients will need a re-intervention (my cycle lengths will be based on the rate of re-intervention). The cohort will have to run through a new treatment strategy + it's possible complications, which is in the decision tree.
How would they go back to a new intervention? Does this mean that I would have to manually add the additional costs/utility values associated with a new treatment strategy + complications for the proportion of the cohort that requires re-intervention?
Would this be better accomplished with a patient-level simulation?
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