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International Journal of Epidemiology, Volume 33, Number 2, pp. 426-427
IJE vol.33 no.2 © International Epidemiological Association 2004; all rights reserved.

Commentary

Commentary: Evidence synthesis and evidence consistency

AE Ades

MRC Health Research Collaboration, University of Bristol, Bristol BS8 2PR, UK. E-mail: t.ades{at}bristol.ac.uk

The first 10% of the full text of this article appears below.

The paper by van Valkengoed1 is a critique of the way in which investigators have chosen parameter values for cost effectiveness analyses (CEA), but it also suggests a way of looking at evidence that is seriously underused in both epidemiology and medical decision making.

The essential problem is set out schematically in Figure 1. The adult female population is at risk of chlamydial infection; a proportion of those infected develop pelvic inflammatory disease (PID), and PID may in a proportion of cases lead to ectopic pregnancies and/or infertility. Other causal pathways can lead to these outcomes, although it may be possible to determine approximately what proportion of them can be attributed to chlamydia.


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  		Figure 1 Schematic disease progression model for Chlamydia trachomatis infection, with parameters a (prevalence of infection), b the probability of pelvic inflammatory disease (PID) . . . [Full Text of this Article]

 

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