Table 15:
Effectiveness of Multi-gene Pharmacogenomic-Guided Treatment
| Model Parameter | Mean (SE/95% CI)a,b | Distribution (Parameters)b | Reference |
|---|---|---|---|
| Risk ratio for remission (intervention vs. TAU) | 1.47 (1.12; 1.94) | Lognormal (mean: 0.385; SE: 0.140) | Greden et al, 201957 |
| Relative risk, relapse (intervention vs. TAU) | 0.39 (0.04) | Lognormal (mean: –0.942; SE: 0.0512) | Tanner et al, 202078 |
| Ratio for remission (next treatment vs. initial treatment: step 2d) | 0.83 | NA (fixed) | Rush, 20068 |
| Probability of transitioning to the well state, in those with initial remission (maintenance treatment phase)e • Estimated per monthc,e |
0.66 (0.07) • 0.086 (0.006) |
Beta (α: 29.565; β: 15.231) | Williams et al, 2009108 |
| Probability of side effects due to treatment with antidepressants | 0.156 (0.015) | Beta (α: 87.204; β: 471.796) | Greden et al, 201957 |
Abbreviations: CI, confidence interval, NA, not applicable; SE, standard error; TAU, treatment as usual.
Standard errors were estimated whenever data were available; those associated with relapse outcomes were assumed to be 10% of mean.
Beta and lognormal distributions were assigned for probabilities and risk ratio (relative risk), respectively, in probabilistic analysis. Two parameters of the beta distribution (α, β) were derived from the mean and SE (stated for each model parameter). Two parameters of the lognormal distribution were μ (mean of logs) and σ (SE, standard deviation of logs). Distribution parameter values were based on original data; further adjustments and transformations to model cycle length of 1 month were performed.
Markov model used a cycle length of 1 month and all rates and probabilities were adjusted appropriately.
When a person did not benefit from initial treatment assigned at baseline and started a second treatment, probability of remission was decreased (by 0.83 times) compared with baseline as shown in the STARD∗D trial for the step 2 treatment: probability of remission with step 1 ÷ probability of remission with step 2: 0.366/0.306 = 0.83.8
Well health state was included in a scenario analysis only.