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Statistical Methods in Medical Research
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Estimating the population impact of an intervention: a decision-analytic approach

Adam L Hersh

Center for the Evaluative Clinical Sciences, Department of Community and Family Medicine, Hanover, New Hampshire, USA

William C Black

Center for the Evaluative Clinical Sciences, Department of Community and Family Medicine, and Department of Radiology Hanover, New Hampshire, USA

Anna NA Tosteson

Center for the Evaluative Clinical Sciences, Department of Community and Family Medicine, and Department of Medicine, Dartmouth Medical School, Hanover, New Hampshire, USA, anna.n.a.tosteson{at}dartmouth.edu

The aim of this paper is to highlight the role for decision analysis in assessing outcomes of medical interventions at a population level. The basic steps of decision analysis are introduced and an illustrative hypothetical preventive intervention is examined. Specific modelling challenges that arise when estimating the population impact of an intervention are described and each is accompanied by an example. Decision analysis can provide useful information for health policy decision makers by identifying the intervention(s) with the largest beneficial impact on health over a wide range of assumptions. In addition, by focusing attention on the parameters with the greatest influence on projected outcomes, decision analysis can aid in identifying critical areas for future research.

Statistical Methods in Medical Research, Vol. 8, No. 4, 311-330 (1999)
DOI: 10.1177/096228029900800404
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