The Critical Role of Validation in Health Economic Modeling

By João L. Carapinha

January 24, 2024

In this article, we review an editorial by Stephanie Harvard in PharmacoEconomics. It’s all about the crucial role of stakeholder involvement in health economics modeling. Let’s unpack the three key takeaways from this editorial and then explore some alternative viewpoints including validation in health economic modeling .

Elaborated Key Takeaways:

1. Critical Role of Diverse Stakeholders: Stephanie presents why diverse stakeholder involvement is vital. She argues that when stakeholders from various backgrounds—patients, policymakers, clinicians—collaborate, the resulting models are more reflective of real-world needs. It’s not just about gathering opinions; it’s about integrating these insights into models that shape health policy and practices.

2. Complexities of Standardizing Stakeholder Involvement: Stephanie acknowledges the complexity in standardizing stakeholder involvement. She explores the balance between having enough diversity and maintaining manageability in the process. It’s a delicate act, ensuring all voices are heard while also keeping the modeling process efficient and focused.

3. Advancing Participatory Modeling: The article goes further, advocating for the health economics community to actively foster an environment where stakeholder participation isn’t just an afterthought. Stephanie envisions a culture where participatory modeling becomes the norm, driven by supportive policies and community practices.

Validation in Health Economic Modeling

In discussing stakeholder involvement, Stephanie surprisingly doesn’t discuss validation methods. In a field where empirical evidence is paramount, understanding how these inclusive models are validated is crucial.

Validation in modeling is crucial for several reasons:

  1. Accuracy: Validation ensures the model accurately represents the real-world system it’s designed to emulate. This is vital for the model’s credibility and usefulness in decision-making.
  2. Reliability: It tests the reliability of the model’s predictions, confirming that the model consistently produces reasonable and repeatable results.
  3. Confidence Building: By validating a model, stakeholders can have confidence in its predictions, which is essential when models are used to inform significant decisions or policies.
  4. Identifying Errors: Validation helps identify and correct errors in the model, whether in the assumptions, data inputs, or computational processes.
  5. Adaptability: It allows for the assessment of a model’s adaptability to different scenarios and conditions, ensuring its applicability in various contexts.

Academic and Government Disconnect

Moving to the next point, my sense is that academics and governments, the usual suspects in stakeholder discussions, might be too removed from the on-the-ground realities. While their expertise is invaluable, they should be actively engaging with a broader range of stakeholders, not just dictating models from an ivory tower.

Plurality in Modeler’s Values

Regarding the modeler’s values, Stephanie’s assumption of representing a singular reality through stakeholder collaboration is contentious. In reality, there are multiple perspectives, each valid in its own right. A more pluralistic approach, embracing a variety of thoughts and ideas, might be more effective than trying to adhere to a perceived ‘universal’ reality. This diversity could lead to richer, more adaptable models that are truly representative of the complex healthcare landscape. In the process, Stephanie seems to undervalue the input from small, homogenous groups. There’s a risk that her approach could lead to cumbersome, bureaucratic processes, potentially causing delays on patient access to innovative technologies. Also, setting a minimum standard for stakeholder involvement might not be necessary. In a market of ideas, let the best models naturally attract attention and resources, and let those be implemented.

Conclusion

In summary, Stephanie’ article prompts a vital discussion on stakeholder involvement in health economics modeling. It challenges us to think beyond traditional methods, advocating for inclusivity and diversity. Yet, it also opens the door for debate on the practicality and philosophical underpinnings of such approaches. It’s a conversation that’s as challenging as it is necessary in our pursuit of models that truly reflect the multifaceted nature of healthcare.

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