Meeting round-up: Health Economists’ Study Group (HESG) Winter 2019

2019 started with aplomb with the HESG Winter meeting, superbly organised by the Centre for Health Economics, University of York.

Andrew Jones kicked off proceedings with his brilliant course on data visualisation in health econometrics. The eager audience learnt about Edward Tufte’s and others’ ideas about how to create charts that help to make it much easier to understand information. The course was tremendously well received by the HESG audience. And I know that I’ll find it incredibly useful too, as there were lots of ideas that apply to my work. So I’m definitely going to be looking further into Andrew’s chapter on data visualisation to know more.

The conference proper started in the afternoon. I had the pleasure to chair the fascinating paper by Manuela Deidda et al on an economic evaluation using observational data on the Healthy Start Voucher, which was discussed by Anne Ludbrook. We had an engaging discussion, that not only delved into the technical aspects of the paper, such as the intricacies of implementing propensity score matching and regression discontinuity, but also about the policy implications of the results.

I continued with the observational data theme by enjoying the discussion led by Panos Kasteridis on the Andrew McCarthy et al paper. Then I quickly followed this by popping over to catch Attakrit Leckcivilize’s excellent discussion of Padraig Dixon’s et al paper on the effect of obesity on hospital costs. This impressive paper uses Mendelian randomisation, which is a fascinating approach using a type of instrumental variable analysis with individuals’ genetic variants as the instrument.

The meeting continued in the stunning setting of the Yorkshire Museum for the plenary session, which also proved a fitting location to pay tribute to the inspirational Alan Maynard, who sadly passed away in 2018. Unfortunately, I was unable to hear the tributes to Alan Maynard in person, but fellow attendees were able to paint a moving portrait of the event on Twitter, that kept me in touch.

The plenary was chaired by Karen Bloor and included presentations by Kalipso Chalkidou, Brian Ferguson, Becky Henderson and Danny PalnochJane Hall, Steve Birch and Maria Goddard gave personal tributes.

The health economics community was united in gratitude to Professor Alan Maynard, who did so much to advance and disseminate the discipline. It made for a wonderful way to finish day 1!

Day 2 started bright and was full of stimulating sessions to choose from.

I chose to zone in on the cost-effectiveness topic in particular. I started with the David Glynn et al paper about using “back of the envelope” calculations to inform funding and research decisions, discussed by Ed Wilson. This paper is an excellent step towards making value of information easy to use.

I then attended Matthew Quaife’s discussion of Matthew Taylor’s paper on the consequences of assuming independence of parameters to decision uncertainty. This is a relevant paper for the cost-effectiveness world, in particular for those tasked with building and appraising cost-effectiveness models.

Next up it was my turn in the hot seat, as I presented the Jose Robles-Zurita et al paper on the economic evaluation of diagnostic tests. This thought-provoking paper presents a method to account for the effect of accuracy on the uptake of the test, in the context of maximising health.

As always, we were spoilt for choice in the afternoon. The paper “Drop dead: is anchoring at ‘dead’ a theoretical requirement in health state valuation” by Chris Sampson et al, competed very strongly with “Is it really ‘Grim up North’? The causes and consequences of inequalities on health and wider outcomes” by Anna Wilding et al, for the most provocative title. “Predicting the unpredictable? Using discrete choice experiments in economic evaluation to characterise uncertainty and account for heterogeneity”, from Matthew Quaife et al, also gave them a run for their money! I’ll leave a sample here of the exciting papers in discussion, so you can make your own mind up:

Dinner was in the splendid Merchant Adventurers’ Hall. Built in 1357, it is one of the finest Medieval buildings in the UK. Another stunning setting that provided a beautiful backdrop for a wonderful evening!

Andrew Jones presented the ‘Health Economics’ PhD Poster Prize, sponsored by Health Economics Wiley. Rose Atkins took the top honours by winning the Wiley prize for best poster. With Ashleigh Kernohan’s poster being highly commended, given its brilliant use of technology. Congratulations both!

Unfortunately, the vagaries of public transport meant I had to go home straight after dinner, but I heard from many trustworthy sources, on the following day, that the party continued well into the early hours. Clearly, health economics is a most energising topic!

For me, day 3 was all about cost-effectiveness decision rules. I started with the paper by Mark Sculpher et al, discussed by Chris Sampson. This remarkable paper sums up the evidence on the marginal productivity of the NHS, discussing how to use it to inform decisions, and proposes an agenda for research. There were many questions and comments from the floor, showing how important and challenging this topic is. As are so many papers in HESG, this is clearly one to look out for when it appears in print!

The next paper was on a very different way to solve the problem of resource allocation in health care. Philip Clarke and Paul Frijters propose an interesting system of auctions to set prices. The paper was well discussed by James Lomas, which kick-started an animated discussion with the audience about practicalities and implications for investment decisions by drug companies. Great food for thought!

Last, but definitely not least, I took in the paper by Bernarda Zamora et al on the relationship between health outcomes and expenditure across geographical areas in England. David Glynn did a great job discussing the paper, and especially in explaining data envelopment analysis. As ever, the audience was highly engaged and put forward many questions and comments. Clearly, the productivity of the NHS is a central question for health economics and will keep us busy for some time to come.

As always, this was a fantastic HESG meeting that was superbly organised, providing an environment where authors, discussants and participants alike were able to excel.

I really felt a feeling of collegiality, warmth and energy permeate the event. We are part of such an amazing scientific community. Next stop, HESG Summer meeting, hosted by the University of East Anglia. I’m already looking forward to it!

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