ANALISIS KEPUTUSAN (DECISION ANALYSIS).pptx

materi analisis keputusan

1. ANALISIS KEPUTUSAN (DECISION ANALYSIS) Decision Analysis “Systematic quantitative approach for assessing the relative value of one or more different decision options”

2. Langkah-Langkah Dalam Decision Analysis Identifikasi Keputusan yg spesifik Keputusan yg akan dievaluasi didefinisikan dgn jelas Apakah tujuan dr penelitian? Berapa lama analisis akan dilakukan? Dari perspektif mana penelitian dilakukan? Contoh : keputusan untuk menentukan apakah antibiotika yg baru bisa ditambahkan dalam formularium? Perspektif : institusi Lama analisis : episode terapi ( sekitar 2 minggu)

3. Langkah-Langkah Dalam Decision Analysis Menentukan alternatif terapi yang paling efektif Terapi standard membandingkan 2 atau lebih pilihan terapi 5 macam obat golongan statin Intervensi vs tanpa intervensi Contoh : antibiotika baru (A) dengan antibiotika standar yang sudah digunakan (B)

4. Langkah-Langkah Dalam Decision Analysis Menggambar struktur analisis keputusan Terdiri dari : choiche nodes, chance nodes, & terminal nodes Choiche nodes merupakan pilihan keputusan (misal antibiotika A & antibiotika B) Chanche nodes : kemungkinan yang akan terjadi (misalnya, probabilitas sembuh atau mengalami efek samping) Terminal nodes : outcome akhir dari pilihan yang dibuat (dalam nilai mata uang atau QALYs)

5. Struktur pohon keputusan Infection Antibiotic A Antibiotic B Clinical succes Clinical failure Clinical succes Clinical failure No adverse events Adverse events No adverse events No adverse events No adverse events Adverse events Adverse events Adverse events

6. Langkah-Langkah Dalam Decision Analysis Menentukan biaya, outcome, dan probabilitas Probabilitas pd setiap chance nodes & nilai = 1 Konsekuensi : outcome moneter, outcome terkait kesehatan, atau keduanya.

7. Estimates for Antibiotic Example Antibiotic A Antibiotic B Probability of clinical succes 90% 80% Cost of antibiotic per course of therapy $600 $500 Probability of adverse events 10% 15% Cost of treating adverse events $1000 $1000

8. Langkah-Langkah Dalam Decision Analysis Menghitung perkiraan biaya per terapi Expected Value = nilai A x probabilitas A + nilai B X probabilitas +………….+ nilai n x probabilitas n ICER = Δ costs = $700 - $650 = $500 utk tiap keberhasilan Δ outcomes 0,90 – 0,80

9. Calculation for the Antibiotic example outcome cost probability Cost x probability Antibiotic A Succes with no adverse events $600 0,9 x 0,9 = 0,81 $486 Succes with adverse events $600+$1000 0,9 x 0,1 = 0,09 $144 Failure with no adverse events $600 0,1 x 0,9 = 0,09 $ 54 Failure with adverse events $600+$1000 0,1 x 0,1 = 0,01 $ 16 Total for antibiotic A 1 $700 Antibiotic B Succes with no adverse events $500 0,8 x 0,85 = 0,68 $340 Succes with adverse events $500+$1000 0,8 x 0,15 = 0,12 $180 Failure with no adverse events $500 0,2 x 0,85 = 0,17 $ 85 Failure with adverse events $500+$1000 0,2 x 0,15 = 0,03 $ 45 Total for antibiotic A 1 $650

10. Infection Antibiotic A Antibiotic B Clinical succes Clinical failure Clinical succes Clinical failure No adverse events Adverse events No adverse events No adverse events No adverse events Adverse events Adverse events Adverse events Antibiotic B : $650 $700 $650 0,90 0,10 0,80 0,20 0,90 0,10 0,90 0,10 0,85 0,15 0,85 0,15 (1) $600 (2) $1600 (3) $600 (4) $1600 (5) $500 (6) $1500 (7) $500 (8) $1500

11. Sensitivity Analysis for the Antibiotic Example variable Range : low estimate – high estimate Antibiotic A : overall costs Antibiotic B: overall costs Δ overall costs : A-B Base case $ 700 $ 650 + $50 Cost of treating adverse events L=$500 H=$2500 $650 $850 $575 $875 +$75 -$25 Cost per course of therapy for Antbc. A L=$400 H=$800 $500 $900 $650 $650 -$150 +$250 Cost per course of therapy for Antbc. B L=$350 H=$750 $700 $700 $500 $900 +$200 -$200 Probability of adverse events for Antbc. A L=7% H=15% $670 $750 $650 $650 +$20 +$100 Probability of adverse events for Antbc. B L=10% L=25% $700 $700 $600 $750 +$100 -$50

12. Thank You