Meeting round-up: EuroQol Plenary Meeting 2017

The 34th Plenary Meeting of the EuroQol Group took place in Barcelona on 21st and 22nd September 2017. The local hosts of the meeting were Mike Herdman (UK-born but a Barcelona resident for many years), Juan Manuel Ramos-Goñi and Oliver Rivero-Arias. For the second year running, I chaired the Scientific Programme together with Anna Lugnér.

At its inception, the EuroQol Group was very much a northern European collaboration – the early versions of the EuroQol instrument (now known as the EQ-5D) were developed by researchers in the Netherlands, UK, Sweden, Finland and Norway – see here for an overview of the Group and its history. This year’s Plenary Meeting was attended by 111 participants (primarily academic researchers) representing 23 different countries spanning six continents.

As with previous Plenary Meetings, an HESG-style discussant format was followed – papers were pre-circulated to participants and presented by discussants rather than by authors. The parallel poster sessions also followed a discussant format, with approximately 10 minutes dedicated to the discussion of each poster. In total, 19 papers and 20 posters were presented. For the first time, the majority of the papers were lead-authored by women.

One of the themes of the meeting was a focus on the relationships and interactions between EQ-5D dimensions. A paper by Anna Selivanova compared health state values derived from discrete choice data both with and without interactions. Anna reported results demonstrating that interactions are important and that the interaction between mobility and self-care was the most salient. Another paper by Thor Gamst-Klaussen (represented at the meeting by co-author Jan Abel Olsen) explored the causal and effect nature of EQ-5D dimensions. The authors applied confirmatory tetrad analysis and confirmatory factor analysis to multi-country, cross-sectional data in order to test a conceptual framework depicting relationships among the five dimensions. The results suggest that the EQ-5D comprises both causal variables – mobility, pain/discomfort and anxiety/depression – and effect variables – self-care and usual activities.

An intriguing paper by John Hartman tested for differences in respondent characteristics, participation, response quality and EQ-5D-5L values depending on the device and connection used to access an online survey. The results showed systematic variability in participation and response quality, but the variability did not affect the resulting health state values. The findings could support extending the administration of valuation surveys to smaller devices (e.g. mobile phones) to obtain responses from younger, more ethnically diverse populations who have traditionally been found to be difficult to recruit.

Other topics covered in the programme included the views of UK decision makers on the role of well-being in resource allocation decisions, the development of a value set for the EQ-5D-Y (a version of the EQ-5D designed for use in children and adolescents), and the prevalence and impact of so-called ‘implausible’ health states.

The Plenary Meeting concluded with a guest presentation by Janel Hanmer of the University of Pittsburgh, followed by a reception at a restaurant on the Montjuïc hill overlooking the Barcelona harbour. The next EuroQol conference will be the Academy Meeting, which takes place in Budapest on 6-8 March 2018.

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Meeting round-up: Fourth EuHEA PhD Student-Supervisor and Early Career Researcher Conference

The 4th catchily-titled EuHEA PhD Student-Supervisor and Early Career Researcher (ECR) conference took place from 6th–8th September 2017 in Lausanne, Switzerland. Students and ECRs can attend alone but are encouraged to bring their supervisors or other senior colleagues with them, who are then allocated as discussants.

With a format inspired by the UK HESG meeting, papers are pre-circulated and each given an hour session. The student or ECR first presents their paper for 25 minutes, followed by a 15-minute discussion from an allocated senior delegate. The floor is then opened to the audience for a further 20 minutes of discussion. This format enables students and ECRs to gain experience in both writing and presenting their work, in addition to receiving detailed feedback and suggestions for future directions.

45 papers were presented in total, and the overall standard of the work was exceptional. Four parallel sessions ran, roughly grouped into the themes of: economic evaluation of medical technologies; economics of health system financing, regulation and delivery; determinants of health behaviours and consequences; and patient and provider decision making and incentives. So there really was something for everyone. There were also short 10-minute presentation sessions. I really enjoyed these quick overviews and felt that I learnt more about people’s research from these than a traditional poster session.

The atmosphere is purposefully relaxed and friendly, and it was great to see students and ECRs contributing to the discussions just as much as their senior supervisors. The conference also seems to attract repeat attendance and so is beginning to form a supportive network of junior health economists who now meet annually. As one of the organisers of the first conference in Manchester, a personal highlight for me was seeing delegates who had originally attended as PhD students returning this time in the role of supervisor as their careers have progressed.

Ieva Sriubaite had the rather daunting but invaluable opportunity to have her paper “Go your own way? The importance of peers in the formation of physician practice styles” discussed by Prof Amitabh Chandra from Harvard, who also gave the plenary speech. Whilst the conference programme was packed, there were still plenty of opportunities to socialise, and a cultured trip to The Hermitage Foundation.

An initiative to come out of the previous conference is the formation of a EuHEA Early Career Committee, which will represent the interests of health economists at the start of their careers within EuHEA. I had the great honour of being elected to chair this committee, and we held our first committee meeting during the conference. Watch out for updates on our best idea to come from this meeting – a conference cruise.

For now, hold 5th–7th September 2018 in your diaries and book your flights to Sicily for the 5th conference. If that location doesn’t convince you to attend I don’t know what will.

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Meeting round-up: 7th annual Vancouver Health Economics Methodology (VanHEM) meeting

The 7th annual Vancouver Health Economics Methodology (VanHEM) meeting took place on June 16 in Vancouver, Canada. This one-day conference brings together health economists from across the Pacific Northwest, including Vancouver, Washington State, and Calgary. This has always been more than a Vancouver meeting, which led Anirban Basu from Washington State to suggest changing the name of the meeting to the Cascadia Health Economics Workshop (CHEW) – a definite improvement.

This year’s event began a day early, with Richard Grieve from the London School of Hygiene and Tropical Medicine, Stephen O’Neill from NUI Galway, and Jasjeet Sekhon from the University of California Berkeley, delivering a workshop titled Methods for Addressing Confounding in Comparative Effectiveness and Cost-effectiveness Studies. This provided both theoretical and practical examples of propensity score matching, genetic matching, difference-in-difference estimation and the synthetic control method. I was fortunate enough to be one of the 16 attendees (it was oversubscribed) to participate after being unable to attend when the course was offered at the Society for Medical Decision Making conference this past October. The course was an excellent introduction to these methodologies, including both theoretical and empirical examples of their use. I was particularly interested to have R and Stata code provided, to work through real-world examples. Being able to see the data and code and explore different analyses provided an incredibly rich learning experience.

The following morning, Prof Grieve delivered the plenary address to the more than 80 attendees. This talk discussed the potential for causal inference and large-scale data to influence policy, and outlined how observational data can complement evidence from randomized controlled trials (the slides are available here [PDF]). Since the expertise of our health economics community centres on other methods, primarily economic evaluation and stated preference methods, Prof Grieve’s plenary catalyzed a lot of discussion, which continued throughout the day. After the plenary, there were eight papers discussed over four parallel sessions, in addition to ten posters presented over lunch. This included an interesting paper by Nathaniel Hendrix from Washington state on a mapping algorithm between a generic and condition-specific quality-of-life measure for epilepsy, and two papers using discrete choice methodology. One by Tracey-Lea Laba evaluated cost sharing for long-acting beta-agonists in Australia, and another by Dean Regier, Verity Watson and Jonathon Sicsic explored choice certainty and choice consistency in DCEs using Kahneman’s dual processing theory.

Having been to three HESG meetings, there are lots of similarities with the format of VanHEM. For instance, papers are discussed for 20 minutes by another attendee, and the author has 5-minutes for clarification. What is different is that before a wider discussion, members of the audience break into small groups for 5 minutes. In my experience, this addition has been very effective at increasing participation during the final 25 minutes of the session, which is an open discussion amongst all attendees. It also gave attendees the opportunity to swap tips on where to find the best deals on plaid shirts.

I was fortunate enough to have my paper accepted and discussed by Prof Larry Lynd from the UBC Faculty of Pharmaceutical Science. Prof Lynd provided a number of excellent suggestions. Of particular note was a much simpler and more intuitive description of the marginal rate of substitution.

VanHEM also afforded an opportunity for discussion and reflection within the local health economics community. Recently, the Canadian Institutes for Health Research launched the Strategy for Patient-Oriented Research (SPOR). In BC, this involves an $80 million investment to “foster evidence-informed health care by bringing innovative approaches to the point of care, so as to ensure greater quality, accountability, and access of care”. One innovative approach is the creation of a new health economics methods cluster in the province, which is co-led by David Whitehurst (Simon Fraser University) and Nick Bansback (University of British Columbia). It receives SPOR funds to help support the health economics community as a whole, and specific research projects that focus on novel methods. At VanHEM, one hour was dedicated to determining how the cluster could help support the community that sees many health economists located at different sites throughout the region. Participants suggested having a number of dedicated academic half-days throughout the year that aim to provide an opportunity for members of the community to see each other face-to-face and engage in activities that support professional development. The theme of great titles continued with the suggestion of a “HEck-a-thon”.

Overall, this year’s VanHEM meeting was a great success. The addition of a pre-meeting workshop provided an excellent opportunity for our community to gain practical experience in causal methods, and we continue to see increased numbers of participants from outside our local region. I’m looking forward to doing this again in 2018, and I would encourage anyone visiting our region to be in touch!

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