Is expert opinion reliable when estimating transition probabilities? The case of HCV-related cirrhosis in Egypt.

Anthony Cousien 1, 2, * Dorothée Obach 1, 2 Sylvie Deuffic-Burban 2, 3 Aya Mostafa 4 Gamal Esmat 5 Valérie Canva 6 Mohamed El Kassas 7 Mohammad El-Sayed 5 Wagida Anwar 4 Arnaud Fontanet 8, 9 Mostafa Mohamed 4 Yazdan Yazdanpanah 2, 10
* Auteur correspondant
1 CERIM - Santé publique : épidémiologie et qualité des soins-EA 2694
2 IAME - Infection, Antimicrobiens, Modélisation, Evolution
3 Inflammation: mécanismes et régulation et interactions avec la nutrition et les candidoses
4 Department of Community, Environmental and Occupational Medicine
5 Department of Endemic Medicine and Hepatology
6 Service d'hépato-gastro-entérologie
7 National Hepatology and Tropical Medicine Research Institute
8 Chaire Santé et Développement
9 Epidémiologie des Maladies Emergentes
10 Service des maladies infectieuses et tropicales
Abstract : BACKGROUND: Data on HCV-related cirrhosis progression are scarce in developing countries in general, and in Egypt in particular. The objective of this study was to estimate the probability of death and transition between different health stages of HCV (compensated cirrhosis, decompensated cirrhosis and hepatocellular carcinoma) for an Egyptian population of patients with HCV-related cirrhosis. METHODS: We used the "elicitation of expert opinions" method to obtain collective knowledge from a panel of 23 Egyptian experts (among whom 17 were hepatologists or gastroenterologists and 2 were infectiologists). The questionnaire was based on virtual medical cases and asked the experts to assess probability of death or probability of various cirrhosis complications. The design was a Delphi study: we attempted to obtain a consensus between experts via a series of questionnaires interspersed with group response feedback. RESULTS: We found substantial disparity between experts' answers, and no consensus was reached at the end of the process. Moreover, we obtained high death probability and high risk of hepatocellular carcinoma. The annual transition probability to death was estimated at between 10.1% and 61.5% and the annual probability of occurrence of hepatocellular carcinoma was estimated at between 16.8% and 58.9% (depending on age, gender, time spent in cirrhosis and cirrhosis severity). CONCLUSIONS: Our results show that eliciting expert opinions is not suited for determining the natural history of diseases due to practitioners' difficulties in evaluating quantities. Cognitive bias occurring during this type of study might explain our results.
Keywords : Delphi method Expert knowledge elicitation Methodological bias Risk perception Cognitive bias HCV in Egypt
Type de document :
Article dans une revue
BMC Medical Research Methodology, BioMed Central, 2014, 14 (1), pp.39. 〈10.1186/1471-2288-14-39〉
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http://www.hal.inserm.fr/inserm-00980899
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Soumis le : samedi 19 avril 2014 - 10:28:36
Dernière modification le : jeudi 13 septembre 2018 - 16:14:02
Document(s) archivé(s) le : lundi 10 avril 2017 - 15:45:38

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PASTEUR | UNIV-PARIS13 | USPC | IAME | UNIV-HESAM

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Anthony Cousien, Dorothée Obach, Sylvie Deuffic-Burban, Aya Mostafa, Gamal Esmat, et al.. Is expert opinion reliable when estimating transition probabilities? The case of HCV-related cirrhosis in Egypt.. BMC Medical Research Methodology, BioMed Central, 2014, 14 (1), pp.39. 〈10.1186/1471-2288-14-39〉. 〈inserm-00980899〉

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