Markov Influence Diagrams: A Graphical Tool for Cost-effectiveness Analysis. (February 2017)

• Record Type: Journal Article
• Authors: Díez, Francisco J.; Yebra, Mar; Bermejo, Iñigo; Palacios-Alonso, Miguel A.; Calleja, Manuel Arias; Luque, Manuel; Pérez-Martín, Jorge
• Is Part Of: Medical decision making. Volume 37:Number 2(2017)
• Page Start: 183
• Page End: 195
• Publication Date: 2017-02
• Subjects: Markov models -- influence diagrams -- cost-effectiveness analysis -- outcomes research; Medical policy -- Periodicals; Clinical medicine -- Decision making -- Periodicals; Medicine -- Periodicals; Médecine clinique -- Prise de décision -- Périodiques; 362.1
• DOI: 10.1177/0272989X16685088
• Languages: English
• ISSNs: 0272-989X

Abstract

Markov influence diagrams (MIDs) are a new type of probabilistic graphical model that extends influence diagrams in the same way that Markov decision trees extend decision trees. They have been designed to build state-transition models, mainly in medicine, and perform cost-effectiveness analyses. Using a causal graph that may contain several variables per cycle, MIDs can model various patient characteristics without multiplying the number of states; in particular, they can represent the history of the patient without using tunnel states. OpenMarkov, an open-source tool, allows the decision analyst to build and evaluate MIDs—including cost-effectiveness analysis and several types of deterministic and probabilistic sensitivity analysis—with a graphical user interface, without writing any code. This way, MIDs can be used to easily build and evaluate complex models whose implementation as spreadsheets or decision trees would be cumbersome or unfeasible in practice. Furthermore, many problems that previously required discrete event simulation can be solved with MIDs; i.e., within the paradigm of state-transition models, in which many health economists feel more comfortable.