Most health economic analyses are undertaken with the aid of computers.
However, the ethical dimensions of implementing health economic models as
software (or computational health economic models (CHEMs)) are poorly
understood. We propose that developers and funders of CHEMs share ethical
responsibilities to (i) establish socially acceptable user requirements and
design specifications; (ii) ensure fitness for purpose; and (iii) support
socially beneficial use. We further propose that a transparent (T), reusable
(R) and updatable (U) CHEM is suggestive of a project team that has largely
fulfilled these responsibilities. We propose six criteria for assessing CHEMs:
(T1) software files are open access; (T2) project team contributions and
judgments are easily identified; (R1) programming practices promote
generalisability and transferability; (R2) licenses restrict only unethical
reuse; (U1) maintenance infrastructure is in place; and (U2) new releases are
systematically retested and appropriately deprecated. To facilitate CHEMs that
meet TRU criteria, we have developed a prototype software framework in the
open-source programming language R. The framework comprises six code libraries
for authoring CHEMs, supplying CHEMs with data and undertaking analyses with
CHEMs. The prototype software framework integrates with services for software
development and research data archiving. We determine that an initial set of
youth mental health CHEMs we developed with the prototype software framework
wholly meet criteria T1-2, R1-2 and U1 and partially meet criterion U2. Our
assessment criteria and prototype software framework can help inform and
improve ethical implementation of CHEMs. Resource barriers to ethical CHEM
practice should be addressed by research funders.Comment: 17 pages, 4 tables, 1 figur