{predictNMB}

Rex Parsons

The next hour of your life

  • Who am I?
  • Who are you?
  • What is a clinical decision support system?
  • Why we should consider costs and use {predictNMB}
  • THE ENTIRE FIELD OF HEALTH ECONOMICS
  • coding with {predictNMB}

Who am I?

Who am I?

Who am I?

Who am I?

Who am I?

Who am I?

Who am I?

Currently:

PhD Candidate and Senior Research Assistant at AusHSI (QUT)

predictNMB Team:

  • Rex Parsons
  • Adrian Barnett
  • Robin Blythe
  • Steven McPhail(Supervisor)
  • Susanna Cramb(Supervisor)

Who are you?

What is a clinical Decision Support System?

What is a clinical Decision Support System?

annalise.ai’s chest x-ray decision support

  • Assesses chest x-ray for 124 possible outcomes
  • Ranks outcomes and communicates risk to user
  • Highlights areas of image that are influential to risk estimate
  • clinical prediction model
  • reduces/prioritises information
  • model interpretation for better decision (?)

What is a clinical prediction model?

Diagnostic

What is a clinical prediction model?

Prognostic

What is a clinical prediction model?

Prognostic

Why we should consider costs and use {predictNMB}

Why we should consider costs and use {predictNMB}

Why we should consider costs and use {predictNMB}

You’re a health service manager wanting to prevent falls at your hospital

Before you go about evaluating a falls prediction model within a CDSS to assign patients to a falls prevention programme…

Will this be cost-effective or are my healthcare $$$ best spent elsewhere?

This depends on:

  • Model performance
  • Prevalence of falls
  • Cost of falls
  • Intervention effect & cost

Why we should consider costs and use {predictNMB}

You’re a clinical prediction model developer

You’re asked to make a clinical prediction model for inpatient falls to be used in a decision support tool but…

The intervention that they have available is barely effective, very expensive and you know that existing models in similar healthcare settings only have an AUC of 0.7…

Why we should consider costs and use {predictNMB}

{predictNMB}

  • User provides inputs for setting & intervention (w/ uncertainty)
  • Simulates & evaluates clinical prediction models within CDSS
  • Estimates patient benefit and healthcare costs

THE ENTIRE FIELD OF HEALTH ECONOMICS

THE ENTIRE FIELD OF HEALTH ECONOMICS

What you need to know…

  • Healthcare systems are resource constrained
  • Health economics concerns how best to allocate resources to areas of greatest benefit

Quality-adjusted life years (QALYS)

Generic measure of disease burden that considers quality and duration of life

Willingness-to-pay (WTP)

“The maximum price at or below a customer would pay for a product”

AKA

“The price at which a healthcare payer is willing to pay for an additional quality-adjusted life year”

Cost-effectiveness plot

Cost-effectiveness plot

Cost-effectiveness plot

Cost-effectiveness plot

Cost-effectiveness plot

Cost-effectiveness plot

Cost-effectiveness plot

Cost-effectiveness plot

(Incremental) Net Monetary Benefit

NMB: Summary of benefit in monetary terms

\[NMB = QALY \times WTP - Cost_{treatment}\] INB: Difference in NMB between two strategies

\[INB_{treatment} = NMB_{treatment} - NMB_{ref}\]

{predictNMB}

{predictNMB}

What is the expected health economic benefit of using a given (hypothetical) CDSS?

docs.ropensci.org/predictNMB/