Using the weighted area under the net benefit curve for decision curve analysis

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A Bayesian approach to stochastic cost-effectiveness analysis

The aim of this paper is to discuss the use of Bayesian methods in cost-effectiveness analysis (CEA) and the common ground between Bayesian and traditional frequentist approaches. A further aim is to explore the use of the net benefit statistic and its advantages over the incremental cost-effectiveness ratio (ICER) statistic. In particular, the use of cost-effectiveness acceptability curves is examined as a device for presenting the implications of uncertainty in a CEA to decision makers. Although it is argued that the interpretation of such curves as the probability that an intervention is cost-effective given the data requires a Bayesian approach, this should generate no misgivings for the frequentist. Furthermore, cost-effectiveness acceptability curves estimated using the net benefit statistic are exactly equivalent to those estimated from an appropriate analysis of ICERs on the cost-effectiveness plane. The principles examined in this paper are illustrated by application to the cost-effectiveness of blood pressure control in the U.K. Prospective Diabetes Study (UKPDS 40). Due to a lack of good-quality prior information on the cost and effectiveness of blood pressure control in diabetes, a Bayesian analysis assuming an uninformative prior is argued to be most appropriate. This generates exactly the same cost-effectiveness results as a standard frequentist analysis

Thinking outside the box: recent advances in the analysis and presentation of uncertainty in cost-effectiveness studies

As many more clinical trials collect economic information within their study design, so health economics analysts are increasingly working with patient-level data on both costs and effects. In this paper, we review recent advances in the use of statistical methods for economic analysis of information collected alongside clinical trials. In particular, we focus on the handling and presentation of uncertainty, including the importance of estimation rather than hypothesis testing, the use of the net-benefit statistic, and the presentation of cost-effectiveness acceptability curves. We also discuss the appropriate sample size calculations for cost-effectiveness analysis at the design stage of a study. Finally, we outline some of the challenges for future research in this area—particularly in relation to the appropriate use of Bayesian methods and methods for analyzing costs that are typically skewed and often incomplete

Monetary Union and Central Bank Independence

We study the consequences of forming a monetary union among a group of countries where the central banks lack independence and are pressured frequently to accommodate government objectives. This is a common situation in the developing countries. As it is common in the literature, we show that forming a monetary union yields net benefits if output shocks are similar across the member countries and if one or more countries in the union can serve as anchors. Our framework highlights an additional gain from monetary union. We show that the opportunistic objectives of one country's policymakers are kept in check at the union level by other members with disparate objectives. Hence, monetary union can improve the monetary policy for its members if the pressures on the individual central banks are dissimilar. We calibrate the model to evaluate the proposed monetary union in the East African Community. Working Paper 06-5

EPA Guidelines for Regulatory Impact Analysis

On February 17, 1981, the President issued Executive Order 12291 mandating that regulatory agencies must prepare regulatory impact analyses (RIAs) on all major regulations. Before taking action, the agencies must send all RIAs and proposed regulations to the Office of Management and Budget (OMB) for review. These guidelines discuss the analytical techniques that may be used and the information to be developed by the U.S. Environmental Protection Agency when (l) stating the need for the proposed regulatory action; (2) examining alternative approaches to the problem; (3) quantifying benefits and costs and valuing them in dollar terms (where feasible); and (4) evaluating the findings on benefits, costs, and distributional effects. This document provides guidance for preparing Regulatory Impact Analyses. It includes four appendices and one supplement in addition to the main document.

PRINCIPLES OF COST-BENEFIT ANALYSIS

This paper summarizes the procedure for the economic evaluation of government projects and policy reforms. It begins with the social welfare function underpinnings of cost-benefit analysis including the role of distributive weights and the choice of numeraire. It then turns to the conduct of a social cost-benefit analysis using the net present value criterion. This includes the shadow pricing of market products and inputs affected by the project, indirect welfare effects, the opportunity cost of project finance, the evaluation of non-marketed inputs and outputs, and the opportunity cost of risk. Issues involved in selecting a discount rate are discussed, especially those arising from imperfect capital markets. Finally, since many public projects have long-term consequences, the principles that might be used to take account of effects of projects on future generations are outlined. Techniques for accounting for these effects, such as generational accounting, are summarized and its shortcomings highlighted.evaluation, government projects, policy reforms, imperfect capital markets, generational accounting, shadow pricing

Exploring the Trade-offs Between Incentives for Distributed Generation Developers and DNOs

Regulators are aiming to incentivize developers and Distribution Network Operators to connect distributed generation (DG) to improve network environmental performance and efficiency. A key question is whether these incentives will encourage both parties to connect DG. Here, multiobjective optimal power flow is used to simulate how the parties' incentives affect their choice of DG capacity within the limits of the existing network. Using current U.K. incentives as a basis, this paper explores the costs, benefits and tradeoffs associated with DG in terms of connection, losses and, in a simple fashion, network deferral. © 2007 IEEE