Purpose: To understand and describe the opportunities and barriers for using value of information (VOI) methods to prioritize research.
Method: The author reviewed internet and peer-reviewed sources for information on the use of VOI methods to prioritize research. The review was designed to understand methodologies used to conduct VOI research, methods to scale VOI estimation to evaluate a large number of topics simultaneously, the incorporation of VOI estimates into research applications, challenges of standardizing VOI results across studies, and statutory barriers under the Affordable Care Act (ACA) towards the use of quality adjusted life years (QALYs) in VOI analyses by federal advisory groups such as the Patient Centered Outcomes Research Institute (PCORI).
Result: Current methods for estimating VOI are scientifically robust but time consuming to implement. Traditional methods for the nonparametric estimation of the expected value of partial perfect information (EVPPI) offer the most accurate and relevant information but are the most time consuming to implement. Alternatives include shortcut approaches to EVPPI estimation, parametric approaches, minimal and abbreviated model alternatives, model decomposition, and less accurate but more expedient methods such as enveloping VOI based on burden of disease and plausible intervention impact. We identified components of VOI research that should be standardized or reported in a uniform manner to allow for comparisons across studies, but little evidence of proscriptive standards for these inputs or that standards of reporting have been widely adopted in published VOI studies. The review of statutory language contained in the ACA found no language prohibiting the use of QALYs by PCORI to set research priorities.
Conclusion: VOI research offers a quantifiable and replicable methodology to evaluate the opportunity costs that result from suboptimal decisions. However, currently several barriers may limit the use of VOI research to prioritize research. These barriers include scaling VOI methods to evaluate a large number of topics simultaneously, standardizing VOI methods and reporting to allow for cross-study comparisons, addressing uncertainty and misunderstanding regarding the ACA directive on the use of QALYs in VOI research, and disseminating and communicating VOI methods to the health policy community.
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