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. 2024 Jun 25;42(9):955–1002. doi: 10.1007/s40273-024-01399-3

Table 8.

Model uncertainty and validation: peer-reviewed articles (19 articles)

Study (year) Sensitivity analyses reported Face validity Verification of internal validity Cross validity External validity Predictive validity
Aceituno et al. (2018) [20] PSA, DSA NR NR NR All model inputs validated by two hematologists with extensive experience in the treatment of multiple myeloma in Chile NR
Borg et al. (2016) [54] PSA, DSA, scenarios NR NR NR Validated through the submission and the reimbursement application for pomalidomide in Sweden NR
Cai et al. (2019) [27] PSA, DSA NR NR NR NR NR
Campioni et al. (2020) [28] PSA, DSA, scenarios NR NR NR In a recent retrospective analysis of long-term PFS and OS data of Rd patients in the RMG registry, the median PFS and OS values are very closely in line with the predictions of our model NR
Carlson et al. (2018) [29] PSA, DSA, scenarios For curve fitting and drug cost estimates (compared against an analysis performed by Potluri et al. 2015) NR NR NR NR
Dolph et al. (2021) [30] PSA, DSA, scenarios Clinical and health economic expert guidance throughout the development of the model Quality-control validation using a cost-effectiveness model verification checklist Cross-validation performed via an assessment of observed PFS and OS outcomes, against which model outputs were compared Systematic examination of calculations and VBA coding accuracy by external reviewers; results and model approaches compared with previously published relevant economic analyses; validation of external data sources NR
Gueneau et al. (2018) [55] NR NR NR NR NR NR
Jakubowiak et al. (2016) [31] PSA, DSA, scenarios NR NR NR Comparing the estimated total survival for Rd based on the K-GEM to that estimated in a life-time CE model from the UK NHS perspective NR
Jakubowiak et al. (2017) [32] PSA, DSA, scenarios NR Using data from a well-conducted phase III randomized trial that showed superiority of Kd56 over Vd in PFS and OS and the estimation of long-term survival for the Vd arm from matched registry patients NR Using SEER registry data to validate results NR
Kapinos et al. (2023) [33] PSA, DSA NR NR NR NR NR
Karampampa et al. (2023) [56] PSA, DSA, scenarios NR NR NR Validated for long-term estimates of OS and PFS with standard parametric models by clinical experts NR
Matsela et al. (2022) [21] DSA, scenarios NR NR NR NR NR
Nikolaou et al. (2021) [57] PSA, DSA, scenarios Conceptual validity through critical literature review and validated by two key opinion leaders The model was validated according to the AdViSHE checklist by an independent modeling expert NR NR NR
Patel et al. (2021) [34] PSA, DSA, scenarios NR NR NR NR NR
Pelligra et al. (2017) [68] PSA, DSA, scenarios The results of the model were compared with what was expected for each input Model validation and verification was undertaken using the AdViSHE checklist. The conceptual model was reviewed by health economists and clinicians at Celgene NR Validation of the results by comparing the health outcomes for Pd to a recent CE study published in a similar population and comparing the cost results to a study of patients with RRMM in the USA NR
Wong et al. (2021) [35] PSA, DSA, scenarios NR NR NR NR Validity of the chosen distributions by comparing the extrapolated outcomes with the updated survival analysis based on the latest follow-up data and comparing the extrapolated hazard estimates with the observed hazard estimates based on the Kaplan–Meier curves
Zeng et al. (2020) [36] PSA, DSA The Weibull survival model that was selected matched the PFS curves of the trial satisfactorily. In this evaluation, the uncertainty of PFS estimation was verified adequately by the sensitivity analyses NR NR NR NR
Zhang et al. (2018) [37] PSA, DSA, scenarios NR NR NR NR The estimated rate of PFS at 1 or 2 years according to the model were compared to the clinical results of the RCTs

AdViSHE Assessment of the Validation Status of Health-Economic Decision Models, CE cost-effectiveness, DSA deterministic sensitivity analysis, K-GEM Kyprolis Global Economic Model, NHS National Health Service, NR not reported, OS overall survival, Pd pomalidomide plus dexamethasone, PFS progression-free survival, PSA probabilistic sensitivity analysis, RCT randomized controlled trial, Rd lenalidomide and dexamethasone, RMG Registry of Monoclonal Gammopathies, SEER Surveillance, Epidemiology, and End Result, VBA Visual Basic for Applications, Vd bortezomib and dexamethasone