Any discounting to be applied Analysis Reporting of base case results How will the cost-effectiveness be presented, what would be done in the case of dominance?

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Instructions: This course work is in two sections:

Section A)

A critical of a paper: Maximum word count is 1,250 words

Section B) Development of a Modelling plan + outline model structure: Maximum word count is 1,250 words + copy of an outline model structure.

BOTH sections must be completed. The total maximum word count for this course work is 2,500 words + copy of an outline model structure.

You have been provided with a suggested template which you can use to complete Section A and B.

A short scenario has been given to enable you to complete the course work (i will uploed it)

Section A:

Produce a maximum 1,250 word report detailing a critical health economics appraisal of the Nguyen and Bernstein paper (i will be uploaded) using an appropriate critical appraisal tool/framework.

This should include:

  • A succinct critical appraisal of the paper including strengths and limitations.
  • The gaps in this analysis which could be addressed by adapting or undertaking a new health economic analysis using a decision analytical model.

Section B:

Produce a maximum 1,250 word modelling plan for your proposed health economic analysis to fill the gaps in the analysis and address the decision problem. Provide a fully labelled outline of your proposed model structure Consider the following, along with other relevant features, in your modelling plan The aim of the analysis

  • Patient population and any sub-groups to be considered in the analysis.
  • Intervention(s) and comparator
  • Outcomes Model structure
  • The structure of the proposed model (include an outline model structure in your report) with a short description of the treatment pathways to be modelled and health states.
  • Report the computer package you will use to undertake your analysis.
  • State the proposed setting ( country and health service sector) time horizon and perspective for your model with justification Model assumption Briefly describe the main assumptions you will make in your model. Collection of data inputs
  • Resource use and costs—the data and methods you will use to cost up each of your treatment and pathways describing how you will assign values e.g. unit costs and potential sources of information.
  • Clinical data required and which sources of data you would consider and why (including any ranking) e.g. meta-analysis, single RCT, observational, registry data etc. The types of data needed to populate the model e.g. transition probabilities, morbidity, mortality should be outlined
  • Health utilities- the data and methods you will use to populate your model e.g. baseline utility scores, utility decrements as a result of VTE. Describe the preferred method of capturing utilities to be used.
  • Any discounting to be applied Analysis Reporting of base case results How will the cost-effectiveness be presented, what would be done in the case of dominance? Sensitivity analysis Outline the sensitivity analyses to be undertaken to address uncertainty in your model. Feasibility Outline what could be the potential challenges e.g. obtaining high quality clinical evidence

While there have been some improvements in the health and wellbeing of Aboriginal and Torres Strait Islander Australians in recent year, Indigenous Australians are still disadvantaged compared with non-Indigenous Australians (AIHW 2014)

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While there have been some improvements in the health and wellbeing of Aboriginal and Torres Strait Islander Australians in recent year, Indigenous Australians are still disadvantaged compared with non-Indigenous Australians (AIHW 2014). This disadvantage is often the result of a complex range of interrelated economic, cultural, geographical, environmental and social factors that impact up on the health and wellbeing of people of Aboriginal or Torres Strait Islander background.
For this assignment you must identify and discuss four factors that impact on the health and wellbeing of a person of Aboriginal or Torres Strait Islander background. You must provide a discussion of approximately 450 words for each of these four factors. Your response is to be presented as a formal scholarly essay, supported with reliable sources of evidence which have been referenced correctly using the Harvard Referencing System.
DIRECTIONS
The paper must be presented as a formal scholarly essay with the following sections:
Section A – Introduction (100 words)
The introduction should catch the reader’s attention in an interesting way and introduce what will be discussed in the assignment.
Section B – Body of Essay (1800 words)
This section should discuss the four factors that impact on the health of a person of Aboriginal or Torres Strait Islander background (approximately 450 words per factor).
Section C – Conclusion (100 words)
The conclusion presents a brief paragraph that ties together the main points of the assignment, but does not introduce new ideas and generally does not include new literature or direct quotes.
Reference List
A minimum of 8 references (two for each factor discussed) from reliable sources of evidence such as journal articles, textbooks and reports from research centres should support the assignment. They should be referenced correctly using the Harvard Referencing System.

The Genetics of Human Pigmentation and its Relevance to Human Health

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The Genetics of Human Pigmentation and its Relevance to Human Health
Formatting (see also the marking rubric)
The 1500-word report will present information on the genes studied, why they are relevant to human health, the genetic variants that were tested, and a conclusion as to what effect the identified variants might have on health. As the practicals will analyse DNA from a population of anonymous donors, your analysis will involve the combined data of all practical groups. Submission is via Turnitin- a single assignment cover page and submission per pair, listing both members signing the assignment cover page.
Note: you are not required to write an abstract.
The basic format of the research report will be as follows:

1. Title page:
• The title of the study
• A list of Authors (alphabetically for this report), followed by the practical class you are enrolled in.

2. Introduction
The introduction provides background and context for the experiments. It introduces the reader to the genes that are being studied and their importance to human health and disease. Aims must be clearly described.

3. Results
• Figures have figure legends that are placed under each figure. The figure legend does not interpret the figure, but provides information that allows the reader to understand the content of the figure.
• A figure legend should have a brief descriptive title
• Tables do not have legends; tables are identified by a number and a title that is placed above the table
• The text complements the tables and figures; it directs the reader to important findings, but there is no interpretation or discussion of results. It is acceptable to summarise findings: eg. Therefore, this experiment showed that…

4. Discussion
The conclusion will discuss the results in the context of human pigmentation and its significance for human health and disease.
Based on material presented in the lectures, discussions in the practical classes, and your own reading, you are expected to discuss your results in the context of the genetics of the variability of human pigmentation.

The overall word limit is 1500 words: figures and figure legends, tables and references are not included in the word count.

There is not a fixed word count for each section.

Health Economics and Finance

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Health Economics and Finance
Word Count: 1500 excluding References
No. of References: 15.
Requirements: Requesting the author of this assignment to please send me the pdf version of the article that will be reviewed/ critically appraised.
Instructions:
Assignment 2 is an exercise in critical appraisal. You are asked to find a published economic evaluation and critically appraise the work using two popular checklists. Further details follow.

Step 1: Find your economic evaluation. Choose a published evaluation of cost-effectiveness or cost-utility of a health intervention that interests you. Tip: In making your selection, bear in mind the definition of economic evaluation as a comparison of two or more options in terms of their costs and their benefits. Tip: A google search will be more than adequate. I suggest you choose an article published in a public health or medical journal rather than an economics journal. And please obtain a pdf copy of your article that you can send to me.

Step 2: Critically appraise the evaluation Use Drummond’s ten-step checklist to structure your critical appraisal of the article. A copy of the checklist is attached to this document, or it can be found here:
https://www.nlm.nih.gov/nichsr/edu/healthecon/drummond_list.html.

Please use only this ten-question version. There are longer ‘tick-box’ versions of the checklist available (see the reference to Drummond and Jefferson for example), which should not be used. I’ve included the Drummond and Jefferson paper because it provides useful information about what to consider in your review. Feel free to use the 10 main questions as section headings to structure your review. The sub-questions should just be used as prompts to guide what to consider under each section heading. Tip: See the example by Chris Doran for what I have in mind, but note there will be no marks for anyone choosing the same article to critique as the one that Chris reviews! Note also that I am not endorsing his review. He may be wrong in what he says! When you have finished your critique assign a score from 0-100 to reflect your subjective assessment of the study’s quality … give it a mark! Please do this before you consider step 3.

Step 3: Score the article formally using the QHES The Quality of Health Economic Studies instrument is closely related to Drummond’s ten-step checklist but it also allows you to score the quality of the study more formally. There are sixteen questions that you answer yes/ no according to whether you think the article meets the criteria. Each question then has a weight (see Table 1 in the article by Offman). Each yes answer scores 1 and you compute a total quality score for the article by multiplying each yes answer by the weight assigned to that question and summing the result.

Step 4: Compare the results of your two assessments This step is optional – it is not part of the assignment, but may be an interesting exercise. Compare your assessment of the article’s merits in step 2 with the score that you arrive at in step 3. If there is a big difference, perhaps share your reflections on what might be causing it. Any questions of clarification? – Pose them on LMS so that everyone can share the answers
References: Chiou CF et al. Development and validation of a grading system for the quality of cost-effectiveness studies. Medical Care 2003; 41: 32-44. Doran C. Critique of an economic evaluation using the Drummond checklist. Applied Health Economics and Health Policy 2010; 8: 357-359. Drummond M et al. Methods for the Economic Evaluation of Health Care Programmes. 2nd ed. Oxford. Oxford University Press. 1997. Drummond MF, Jefferson TO. Guidelines for authors and peer reviewers of economic submissions to the BMJ. The Economic Evaluation Working Party. British Medical Journal 1996; 313: 275-283. Offman JJ et al. Examining the value and quality of health economic analyses: implications of utilizing the QHES. Journal of Managed Care Pharmacy 2003; 9: 53-61.

3 Checklist for the Economic Evaluation of Health Care Programmes

1. Was a well-defined question posed in answerable form?
1.1. Did the study examine both costs and effects of the service(s) or programme(s)?
1.2. Did the study involve a comparison of alternatives?
1.3. Was a viewpoint for the analysis stated and was the study placed in any particular decision-making context?
2. Was a comprehensive description of the competing alternatives given (i.e. can you tell who did what to whom, where, and how often)?
2.1. Were there any important alternatives omitted?
2.2. Was (should) a do-nothing alternative be considered?
3. Was the effectiveness of the programme or services established?
3.1. Was this done through a randomised, controlled clinical trial? If so, did the trial protocol reflect what would happen in regular practice?
3.2. Was effectiveness established through an overview of clinical studies?
3.3. Were observational data or assumptions used to establish effectiveness? If so, what are the potential biases in results?
4. Were all the important and relevant costs and consequences for each alternative identified?
4.1. Was the range wide enough for the research question at hand?
4.2. Did it cover all relevant viewpoints? (Possible viewpoints include the community or social viewpoint, and those of patients and third-party payers. Other viewpoints may also be relevant depending upon the particular analysis.)
4.3. Were the capital costs, as well as operating costs, included?
5. Were costs and consequences measured accurately in appropriate physical units (e.g. hours of nursing time, number of physician visits, lost work-days, gained life years)?
5.1. Were any of the identified items omitted from measurement? If so, does PHE5HEF 2016 Health Economics and Finance 4 this mean that they carried no weight in the subsequent analysis? 5.2. Were there any special circumstances (e.g., joint use of resources) that made measurement difficult? Were these circumstances handled appropriately?
6. Were the cost and consequences valued credibly?
6.1. Were the sources of all values clearly identified? (Possible sources include market values, patient or client preferences and views, policy-makers’ views and health professionals’ judgements) 6.2. Were market values employed for changes involving resources gained or depleted?
6.3. Where market values were absent (e.g. volunteer labour), or market values did not reflect actual values (such as clinic space donated at a reduced rate), were adjustments made to approximate market values?
6.4. Was the valuation of consequences appropriate for the question posed (i.e. has the appropriate type or types of analysis – cost-effectiveness, cost-benefit, cost-utility – been selected)?
7. Were costs and consequences adjusted for differential timing?
7.1. Were costs and consequences that occur in the future ‘discounted’ to their present values?
7.2. Was there any justification given for the discount rate used?
8. Was an incremental analysis of costs and consequences of alternatives performed?
8.1. Were the additional (incremental) costs generated by one alternative over another compared to the additional effects, benefits, or utilities generated?
9. Was allowance made for uncertainty in the estimates of costs and consequences?
9.1. If data on costs and consequences were stochastic (randomly determined sequence of observations), were appropriate statistical analyses performed?
9.2. If a sensitivity analysis was employed, was justification provided for the range of values (or for key study parameters)?
9.3. Were the study results sensitive to changes in the values (within the assumed range for sensitivity analysis, or within the confidence interval around the ratio of costs to consequences)? 10. Did the presentation and discussion of study results include all issues of concern to users?
10.1. Were the conclusions of the analysis based on some overall index or ratio of costs to consequences (e.g. cost-effectiveness ratio)? If so, was the index interpreted intelligently or in a mechanistic fashion?
10.2. Were the results compared with those of others who have investigated the same question? If so, were allowances made for potential differences in study methodology?
10.3. Did the study discuss the generalisability of the results to other settings and patient/client groups?
10.4. Did the study allude to, or take account of, other important factors in the choice or decision under consideration (e.g. distribution of costs and consequences, or relevant ethical issues)?
10.5. Did the study discuss issues of implementation, such as the feasibility of adopting the ‘preferred’ programme given existing financial or other constraints, and whether any freed resources could be redeployed to other worthwhile programmes?