Reference case methods for expert elicitation in healthcare decision making

Laura Bojke, Marta Soares, Karl Claxton, Abigail Colson, Aimée Fox, Chris Jackson, Dina Jankovic, Alec Morton, Linda D Sharples, Andrea Taylor

Research output: Contribution to journalArticlepeer-review

Abstract

Background
The evidence used to inform healthcare decision-making (HCDM) is typically uncertain. In these situations, the experience of experts is essential to help decision makers reach a decision. Structured expert elicitation (referred to as elicitation) is a quantitative process to capture experts’ beliefs. There is heterogeneity in the existing elicitation methodology used in HCDM and it is not clear if existing guidelines are appropriate for use in this context. In this paper we seek to establish reference case methods for elicitation to inform HCDM.

Methods
We collated the methods available for elicitation using reviews and critique. In addition, we conducted controlled experiments to test the accuracy of alternative methods. We determined the suitability of the methods choices for use in HCDM according to a pre-defined set of principles for elicitation in HCDM, which we have also generated. We determined reference case methods for elicitation in HCDM for Health Technology Assessment (HTA).

Results
In almost all methods choices available for elicitation, we found a lack of empirical evidence supporting recommendations. Despite this it is possible to define reference case methods for HTA. The reference methods include: a focus on gathering experts with substantive knowledge of the quantities being elicited as opposed to those trained in probability and statistics, eliciting quantities that the expert might observe directly, and individual elicitation of beliefs, rather than solely consensus methods. It is likely that there are additional considerations for decision makers in healthcare outside of HTA.

Conclusions
The reference case developed here allows the use of different methods, depending on the decision-making setting. Further applied examples of elicitation methods would be useful. Experimental evidence comparing methods should be generated.
Original languageEnglish
Pages (from-to)1-18
Number of pages18
JournalMedical Decision Making
Publication statusAccepted/In press - 26 May 2021

Keywords

  • healthcare decision-making
  • expert elicitation
  • reference case methods

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