The use of health-economic (HE) decision models can have extensive consequences for payers, patients, and practitioners alike. Since HE models have become a fixed part of the modern decision making process in healthcare policy, they should be validated before they are used. This is commonly done by the modelling team and sometimes extensively so. Since the cost of model validation can be significant, both in time and money, model users, that is, people using the outcomes of the model, such as reimbursement decision makers, could simply presume that the models are valid without further examination. However, this unquestioning acceptance may reduce the users’ overall confidence in the model, especially when the modelling team has an economic interest in favourable outcomes. Model users therefore often validate models themselves, leading to a possibly improved validation status of the model but also an overlap of work between the modelling team and model users. We are thus presented with a trade-off between building confidence in the model and the use of scarce resources.
To address this trade-off, Assessment of the Validation Status of Health-Economic decision models (AdViSHE) was created. This tool provides model users with a structured view into the validation status of the model, according to a consensus on what good model validation entails. It may also provide guidance towards additional validation. AdViSHE, may, for example, be part of dossiers sent to the (national) decision maker when applying for reimbursement, or it may be appended to manuscripts on modelling applications to support peer reviewers.