Systematic assessment of decision models in Parkinson's disease.

摘要: Abstract Objective To give an insight into the structural and methodological approaches used in published decision-analytic models evaluating interventions Parkinson's disease (PD) to derive recommendations for future comprehensive PD decision models. Methods A systematic literature review was performed identify studies that evaluated using mathematical Using a standardized assessment form, information on study design, framework, data sources extracted from each publication systematically reported. Strengths limitations were assessed. Results We identified eight evaluate different pharmaceutical (n = 7) surgical 1) treatment options PD. All included economic evaluations. Modeling comprised equations, trees, Markov with time horizon ranging 5 years lifetime. based progression evolution of clinical surrogate endpoints. Treatment effects either modeled via reduction symptomatic and/or initial improvement or adverse effect rates. No model is currently available encompasses both underlying biologic spectrum all relevant complications also links them patient preferences outcomes. Conclusions Models have been successfully applied treatments. However, substantial limitations. recommend comprehensive, generic, flexible can be strategies should consider large clinically outcomes during sufficiently long horizon, include PD-specific mortality, uncertainty including heterogeneity effects, validated by independent other Approaches progression, improvement, effects. believe bias could avoided if symptoms are separately.