Can knowledgeable experts assess costs and outcomes as if they were ignorant? : An experiment within precision medicine evaluation

Dulsamphan, Thamonwan and Juntama, Parntip and Suwanpanich, Chotika and Isaranuwatchai, Wanrudee and Silzle, Madison and Poonmaksatit, Sathida and Boonsimma, Ponghatai and Shotelersuk, Vorasuk and Visudtibhan, Anannit and Lusawat, Apasri and Kamolvisit, Wuttichart and Kapol, Nattiya and Lochid-amnuay, Surasit and Sribundit, Namfon and Samprasit, Nathapol and Morton, Alec and Teerawattananon, Yot (2023) Can knowledgeable experts assess costs and outcomes as if they were ignorant? : An experiment within precision medicine evaluation. International Journal of Technology Assessment in Health Care, 40 (1). e4. ISSN 1471-6348 (https://doi.org/10.1017/S0266462323002714)

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Abstract

Objectives The purpose of this study is to evaluate the validity of the standard approach in expert judgment for evaluating precision medicines, in which experts are required to estimate outcomes as if they did not have access to diagnostic information, whereas in fact, they do. Methods Fourteen clinicians participated in an expert judgment task to estimate the cost and medical outcomes of the use of exome sequencing in pediatric patients with intractable epilepsy in Thailand. Experts were randomly assigned to either an “unblind” or “blind” group; the former was provided with the exome sequencing results for each patient case prior to the judgment task, whereas the latter was not provided with the exome sequencing results. Both groups were asked to estimate the outcomes for the counterfactual scenario, in which patients had not been tested by exome sequencing. Results Our study did not show significant results, possibly due to the small sample size of both participants and case studies. Conclusions A comparison of the unblind and blind approach did not show conclusive evidence that there is a difference in outcomes. However, until further evidence suggests otherwise, we recommend the blind approach as preferable when using expert judgment to evaluate precision medicines because this approach is more representative of the counterfactual scenario than the unblind approach.

ORCID iDs

Dulsamphan, Thamonwan, Juntama, Parntip, Suwanpanich, Chotika, Isaranuwatchai, Wanrudee, Silzle, Madison, Poonmaksatit, Sathida, Boonsimma, Ponghatai, Shotelersuk, Vorasuk, Visudtibhan, Anannit, Lusawat, Apasri, Kamolvisit, Wuttichart, Kapol, Nattiya, Lochid-amnuay, Surasit, Sribundit, Namfon, Samprasit, Nathapol, Morton, Alec ORCID logoORCID: https://orcid.org/0000-0003-3803-8517 and Teerawattananon, Yot;
CORE (COnnecting REpositories)