Projects

• Enhancing the Evidence Base for Cost-Effectiveness Analysis in Ireland: Building Improvements from the Intervention-Specific to System-Wide Levels.
  Dr James O’Mahony is leading this Health Research Board Emerging Investigator Award (EIA) which contains three principal components. The first addresses the theoretical and empirical basis for the cost-effectiveness threshold used to determine if an intervention represents good value for money. The second examines common methodological problems in cost-effectiveness analyses of cancer screening and proposes a simple simulation modelling framework for use as a teaching and method research tool to help avoid such problems. The final component uses microsimulation modelling to simulate the cost-effectiveness of novel triage techniques for women tested as positive for the human papillomavirus (HPV) at primary screening and to investigate the potential of HPV self-sampling for the prevention of cervical cancer in women who do not typically participate in cervical screening. Dr O’Mahony is accompanied on the EIA programme by doctoral candidate Ms Yi-Shu Lin. James and Yi-Shu work conjunction with the CERVIVA multi-disciplinary research consortium, which investigates the diagnosis and prevention of HPV-associated cancers. Other research partners on the programme include participants based at the Royal College of Surgeons in Ireland and the Erasmus Medical Centre, Rotterdam.
  Last updated 2019
• Optimal screening and management strategies for cervical cancer.
  The overall goal of health economics is to maximise the health gain achieved by health services within available funding. The application to health economics to cervical screening has the particular goal of finding which screening tests will prevent the most disease at an acceptable cost to the health system. The cost-effectiveness of cervical screening depends in part on the interval between screens. If the interval is very short, such as one or two years then screening may impose high costs with little or no benefit over longer screening intervals. Cervical screening at intervals of three to five years as employed in Ireland is thought to be highly cost-effective. Recent developments in screening technology mean that more advanced tests are now available to detect early stages of cervical disease. These new tests include tests for the DNA and RNA of the human papillomavirus. The health economics research in CERVIVA II is to find which new testing technologies will further enhance the cost-effectiveness of Irish cervical screening services. This involves considering the trade-offs of the likely benefits of new tests that are better able to detect disease against the possible costs of false positives and the costs of the testing technologies themselves.
  Last updated 2015

Scientific Papers

• Beware of Kinked Frontiers: A Systematic Review of the Choice of Comparator Strategies in Cost-Effectiveness Analyses of Human Papillomavirus Testing in Cervical Screening
• Dealing with Time in Health Economic Evaluation: Methodological Issues and Recommendations for Practice