Bright line or lottery? On significance and value in medical decision making. Issue 1 (1st January 2021)

• Record Type: Journal Article
• Authors: Mahlich, Jörg; Dheban, Srirangan
• Is Part Of: Journal of market access & health policy. Volume 9:Issue 1(2021)
• Publication Date: 2021-01-01
• Subjects: Value of hope -- statistical significance -- patient preferences -- risk attitudes; Medical policy -- Periodicals; Medical policy -- Economic aspects -- Periodicals; International trade -- Environmental aspects -- Periodicals; Health Policy -- economics; Technology Assessment, Biomedical; Marketing of Health Services; International trade -- Environmental aspects; Medical policy; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 362.1
• DOI: 10.1080/20016689.2021.1981574
• Languages: English
• ISSNs: 2001-6689

Abstract

ABSTRACT: It is widely acknowledged that using p-value thresholds as the basis for making decision on health care spending is not appropriate. In the context of medical decision making, we argue that patient preferences need to be a stronger factor. Depending on attitudes to risk, patients might prefer a medical treatment that performs on average worse than a comparator but offers a small probability of a large gain such as a cure. However, what has been labeled 'value of hope' is not yet fully reflected in the decision-making process of drug approval and health technology assessment (HTA). Therefore, patient risk preferences should be formally incorporated within the decision-making framework for regulatory and reimbursement decisions.