Procedure Manual Appendix XIII. Template for Scoping the “Decision Problem” to Address Through Decision Modeling


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Rationale: A priori articulation of the decisions to be addressed and their desired components is considered a best practice before constructing a model. Equally important is a clear conceptualization of the disease process(es) that must be modeled in order to make the desired modeling-based decisions. These interrelated issues establish the framework for locating relevant existing models, selecting modeling groups for commissioned models, and preparing decision modeling work plans by modeling groups commissioned to undertake modeling for use by the USPSTF.

  1. What aspect(s) of evidence-based decisionmaking for the recommendation statement will require modeling?
    • Screening program details, such as stop and start times or screening intervals.
    • Comparison of available modalities to determine equivalent or best approaches.
    • Specification of high risk or other population selection approaches.
    • Specification of net benefit for interventions with multiple, varying benefits and harms.
    • Other (please specify).
  2. Denote critical PICOTS inclusion or exclusion criteria to help determine the relevance of existing models (Appendix Table 4):
    • Population: Consider geography, patient characteristics (including sociodemographic information and comorbid conditions), disease stages, spectrum of disease, and other factors (family size, family impacts); important subpopulations and the characteristics that define them.
    • Setting: In which countries would models based on their practices and policies be relevant to the United States?
    • Intervention/Comparison/Strategy: Consider the base case and how well it represents current U.S. practice and policy; important alternative strategies (and their variations) that should be addressed, critical service components (including services that might precede or follow the intervention or strategy and affect its effectiveness or assumptions of intervention quality), and any service variations required for important subpopulations.
    • Health outcomes: Deaths, quality-adjusted life years, disability-adjusted life years, incident disease cases, and disease-related health events (benefits and harms).
    • Time horizon: Minimal time horizon to capture relevant differences across strategies (this may or may not be critical at the scoping stage).
    • Intermediate outcomes: Intermediate disease or process outcomes necessary for validation or to determine net impact, such as diagnostic/treatment burden (these may or may not be critical at the scoping stage).
    • Perspective of analysis and policy: Perspective of analysis (i.e., medical sector, societal, health plan) undertaken, funder of model, original intended audience, and original development purpose (these may or may not be critical at the scoping stage).
  3. Based on items 1 and 2, provide a clear written statement of the decision problem/objective and scope that includes disease spectrum, analysis perspective, target population, alternative interventions, health and other outcomes, and time horizon.
  4. If possible, state the key questions that the desired model would address.

Appendix Table 4. PICOTS Table

Category Inclusion Criteria Exclusion Criteria
Condition definition    
Model approach    
Health outcomes    
Intermediate outcomes    
Time horizon    
Model perspective    

Current as of: July 2017
Internet Citation: Appendix XIII. Template for Scoping the “Decision Problem” to Address Through Decision Modeling. U.S. Preventive Services Task Force. July 2017.

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