System and method for determining thresholds of range of values used to allocate patients to a treatment level of a treatment program

Abstract

There is provided a system for determining a threshold value or range of values for results of a test used to assign patients to a particular level of treatment for a clinical condition, the system comprising one or more databases storing historical information on a plurality of patients having the clinical condition, the information including values for the test performed on the patients, information on the treatment level for the clinical condition provided to the patients, there being a plurality of available treatment levels for the clinical condition, information on the outcome of the clinical condition for the patients and information on the cost associated with providing each of the treatment levels to the patients; and a processing module in communication with said one or more databases, the processing module determining a threshold value or range of values for results of the test from the information in said one or more databases, with the threshold value or range of values indicating the most cost effective treatment level for a given test result.

1 . A system for determining a threshold value or range of values for results of a test used to assign patients to a particular level of treatment for a clinical condition, the system comprising:
 one or more databases storing historical information on a plurality of patients having the clinical condition, the information including values for the test performed on the patients, information on the treatment level for the clinical condition provided to the patients, there being a plurality of available treatment levels for the clinical condition, information on the outcome of the clinical condition for the patients and information on the cost associated with providing each of the treatment levels to the patients; and   a processing module in communication with said one or more databases, the processing module determining a threshold value or range of values for results of the test from the information in said one or more databases, with the threshold value or range of values indicating the most cost effective treatment level for a given test result.   
     
     
         2 . The system of  claim 1 , wherein the processing module is configured to determine a threshold value or range of values for results of the test from the information by:
 determining a relationship between values for the test and the health outcome of the clinical condition for each treatment level.   
     
     
         3 . The system of  claim 2 , wherein the processing module is configured to determine the relationship through statistical analysis of the information stored in the one or more databases. 
     
     
         4 . The system of  claim 1 , wherein the processing module is configured to determine a threshold value or range of values for results of the test from the information by:
 determining a relationship between values for the test and the monetary cost outcome for each treatment level.   
     
     
         5 . The system of  claim 4 , wherein the processing module is configured to determine the relationship through statistical analysis of the information stored in the one or more databases. 
     
     
         6 . The system of  claim 1 , wherein the processing module is configured to determine a threshold value or range of values for results of the test from the information by:
 determining a relationship between net health benefits and threshold values or ranges of values.   
     
     
         7 . The system of  claim 6 , wherein the net health benefits are the accumulated effect of said treatment level over a predefined time period minus the total accumulated monetary cost divided by willingness to pay, the willingness to pay being the monetary equivalent to a quality-adjusted life year. 
     
     
         8 . The system of  claim 6 , wherein the processing module is configured to determine the relationship between net health benefits and threshold values or ranges of values by:
 solving a cost-effectiveness model for each treatment level to determine net health benefits for the plurality of patients.   
     
     
         9 . The system of  claim 8 , wherein the cost-effectiveness model comprises a Markov model, differential equations or difference equations. 
     
     
         10 . The system of  claim 8 , wherein the processing module is further configured to determine a threshold value or range of values for results of the test from the information by:
 determining the threshold value or range of values that maximize the net health benefits; and   setting the threshold value or range of values as the threshold value or range of values that maximize the net health benefits.   
     
     
         11 . The system of  claim 8 , wherein the processing module is configured to determine a plurality of estimates of the threshold value or range of values and to solve the cost effectiveness model for each of the plurality of estimates. 
     
     
         12 . The system of  claim 1 , wherein the processing module is configured to determine a threshold value or range of values for results of the test from the information by:
 determining a relationship between values for the test and the amount of patients having values for the test at or below that value.   
     
     
         13 . The system of  claim 1 , wherein the processing module is configured to determine a threshold value or range of values for results of the test for respective groups of patients in the plurality of patients, wherein the respective groups of patients differ from each other in one or more of age, gender, clinical condition, hospital and geographical area. 
     
     
         14 . The system of  claim 1 , wherein the processing module is further configured to receive a result for the test for a patient, compare the result of the test to the determined threshold value or range of values, and to output a recommended treatment level for the patient based on the result of the comparison. 
     
     
         15 . A method of determining a threshold value or range of values for results of a test used to assign patients to a particular level of treatment for a clinical condition, the method comprising:
 obtaining historical information on a plurality of patients having the clinical condition, the information including values for the test performed on the patients, information on the treatment level for the clinical condition provided to the patients, there being a plurality of available treatment levels for the clinical condition, and information on the outcome of the clinical condition for the patients;   obtaining information on the cost associated with providing each of the treatment levels to the patients;   processing the information to determine a threshold value or range of values for results of the test, the threshold value or range of values indicating the most cost effective treatment level for a given test result.   
     
     
         16 . The method of  claim 15 , wherein the step of processing the information to determine a threshold value or range of values for results of the test comprises:
 determining a relationship between values for the test and the health outcome of the clinical condition for each treatment level.   
     
     
         17 . The method of  claim 16 , wherein the step of determining the relationship comprises statistically analyzing the obtained information. 
     
     
         18 . The method of  claim 15 , wherein the step of processing the information to determine a threshold value or range of values for results of the test comprises:
 determining a relationship between values for the test and the monetary cost outcome for each treatment level.   
     
     
         19 . The method of  claim 18 , wherein the step of determining the relationship comprises statistically analyzing the obtained information. 
     
     
         20 . The method of  claim 15 , wherein the step of processing the information to determine a threshold value or range of values for results of the test comprises:
 determining a relationship between net health benefits and threshold values or ranges of values.