Lecture 14

Question 1

Economic analysis

Answer 1

Defines choices in resource allocation

1. Cost minimization
2. Cost effectiveness
3. Cost utility
4. Cost benefit analysis

Question 2

Cost minimization analysis (part of economic analysis)

Answer 2

Directly compares effect of interventions known or assumed to be identical. Ex: brand vs generic

Question 3

Cost effectiveness analysis (part of economic analysis)

Answer 3

Compares effect of interventions expressed in one main variable of natural units. Ex: life. Years gained.

Question 4

Cost utility analysis (part of economic analysis)

Answer 4

Compares interventions whose effect has two or more important dimensions in utility units like QALYs.

Question 5

Cost benefit analysis (part of economic analysis)

Answer 5

Compares different interventions for different conditions in monetary units. Ex: decision to fund heart transplantation or stroke rehabilitation program.

Question 6

Economic analysis. 3 types of costs

Answer 6

Direct- consumables, doctor’s, staff
Indirect- work lost, unpaid work
Intangible- pain and suffering

Question 7

Economic analysis. 3 types of benefits

Answer 7

Economic- preventative care, return to work
Clinical- improved function, symptom relief (myopes)
QoL- Enhancement of life.

Question 8

Vision quality of life index

Answer 8

Focus groups on visually impaired persons key concepts. 
Physical well being
Social well being 
Emotional well being 
Independence 
Self-actualization 
Planning and organization 

Generally, a weighted index of preference is determined on scale from 0 (death) to 1 (perfect health). When this value is known over time, it can be used to compute QALYs

Question 9

QALYs

Answer 9

Utility value x length of time gained.
or
Health state preference value x time pt is likely to be in that health state

Can be used in cost-utility analysis

Question 10

QALYs can be used in which type of analysis

Answer 10

Cost utility

Question 11

Health state preference value

Answer 11

Value a healthy person places on a particular deterioration health, or sick person places on return to health. More useful to medical economists. Continuous scale.

Healthy–> deterioration
Sick –> healthy

Question 12

Time trade off measurement

Answer 12

patient estimates how many remaining years in full health they are willing to sacrifice to be cured.
Ex: would sacrifice 10 years to be fertile.

Question 13

Standard gamble measurement

Answer 13

Patient chooses between A or B.

A: remain in particular state of health
B: Gamble on pursuit of risky therapy given that there are odds of being cured and odds of being killed by intervention.

Odds are varied to find a point patient decides gamble is not worth the risk. Subjective measurement.

can either remain impaired, or gamble on tx and be cured or die.

Question 14

What does QALY stand for

Answer 14

Quality adjusted life years

Question 15

Incremental cost effectiveness ratio (ICER)

Answer 15

Used to compare older, less expensive therapy with newer, more expensive therapy.

(Cost new - Cost old)/ effectiveness new - effective old

Question 16

If cost effectiveness is high, that means

Answer 16

we are willing to pay more money for it.

Question 17

Cost consequences analysis

Answer 17

Expresses different outcomes in terms of natural units. Eg months of survival, legs amputated.

Individuals assign their own values to differing interventions. How they value different forms of treatment.

Question 18

Qualitative(interpretive) researches seek to

Answer 18

Study things in their natural setting. Use holistic perspective.

Question 19

General hypothesis uses deductive reasoning, which is

Answer 19

General principle, then apply to special case.

Question 20

Inductive reasoning uses inductive reasoning

Answer 20

Special case applies to general principle.

Several specific examples used to arrive at general conclusion.

Question 21

Qualitative (interpretive) research

Answer 21

Validity/qualitative strength: Closeness to truth

Triangulation: Combo of methods improves validity of findings.

Reflexivity assesses influence a researchers perspective has on the data. Observer bias.

Inter-rater reliability: more than 1 researcher analyses data and reaches same conclusion.

Progressive focusing: Modify research question in light of findings

Purposive sample: Seek subjects with characteristics you want to study.

Thematic analysis: Come up with ideas, then group. Constant comparative method to refine emerging theory.

Question 22

Difference between research question with qualitative research vs RCT

Answer 22

Qualitative research: Can modify research question in light of findings generated along the way in an iterative approach.

RCT: Now allowed to change mind. Must follow protocol.

Question 23

Questionnaire research must require which 2 components

Answer 23

Must have survey instrument (questionnaire) with items that contain a stem + options.

Question 24

Validated questionnaire

Answer 24

Make sure it measures what it claims to measure.
Enhances credibility.
Required for all new questionnaires.

Question 25

When are questionnaires not appropriate

Answer 25

Ex: prevalence (burden of disease) or professional behaviors.

Question 26

How to analyze questionnaire research (sample types): Stratified random sample

Answer 26

Break samples into groups based on similarities then randomly select.

Question 27

How to analyze questionnaire research (sample types): Snowball sample

Answer 27

Not random. Select a small group of subjects who invite others to participate.

Question 28

How to analyze questionnaire research (sample types) Opportunity/convenience sample

Answer 28

Selecting only subjects who have opportunity to participate- those easily accessible. Very biased.

Question 29

SQUIRE

Answer 29

A questionnaire that promotes excellence in healthcare improvement reporting.