health outcomes

New DPhil (PhD) opportunity in health economics and genomics

James Buchanan Other, Uncategorized , , , , , , , , ,

We have just advertised a new DPhil (PhD) position here at the Health Economics Research Centre in the area of health economics and genomics. The proposed start date is October 2021 and the full title is “Valuing the outcomes associated with genome sequencing in economic evaluations”. The student will be supervised by myself and Professor Sarah Wordsworth.

The primary aim of this project is to evaluate existing instruments used to generate quality of life weights for use in extra-welfarist economic evaluations, in terms of their capacity to capture all impacts of genome sequencing on patient wellbeing. Such instruments will include the EQ-5D-5L, the SF-36 and ICECAP capability measures. We expect the student will: 

  • Critically appraise the theoretical capacity of existing instruments to capture the impacts of genome sequencing;
  • Review the current use of these instruments in this context;
  • Generate new data on the use of these instruments in patients undergoing genome sequencing;
  • Identify instruments that effectively value the outcomes associated with genome sequencing;
  • Describe the characteristics of any new instruments that may be required.

The deadline for applications is 1200 noon UK time on Friday 8th January 2021.

If anybody has any questions about this project then please don’t hesitate to get in touch by email (james.buchanan@dph.ox.ac.uk). Please also share the details of this project with anybody who you think might be interested.

Full details of this project are available here.

Evaluating the Outcomes Associated with Genomic Sequencing

James Buchanan Publication , , , , , , , , , ,

I’ve written about evaluating the outcomes of genomic sequencing a few times in this blog, in the context of several different publications. A key issue here is that we still lack evidence on the health outcomes associated with sequencing, and a commonly cited reason for this is that health economists are unsure as to whether the QALY can fully quantify the outcomes that are important to patients when they undergo genomic testing. There isn’t a great deal of consensus on this matter, or on the issue of whether information on personal utility should feed into resource allocation decisions in this context. This methodological uncertainty may partially explain why existing economic evaluations of genomic sequencing have not gone beyond ‘narrow’ outcome measures such as diagnostic yield.

However, before abandoning QALYs in this clinical context (if this is even possible), I think there are several steps that can and should be taken to improve the evidence base on the clinical and non-clinical utility of genomic sequencing. With this in mind, I recently published an editorial in PharmacoEconomics – Open with Sarah Wordsworth titled “Evaluating the Outcomes Associated with Genomic Sequencing: A Roadmap for Future Research”, in which we expand on what these steps might be. I think this topic should be debated more widely, so if anybody has alternative views on this I’d be happy to hear them!