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Medical Research Council funded PhD studentship

The Centre for Health Economics (CHE) at the University of York is offering
a (3+1 years) Medical Research Council funded Capacity-building studentship
to undertake an MSc and a PhD to start in the 2008/9 academic year.  The
project will focus on methodological issues relating to the analysis of
individual and aggregate patient‑level cost‑effectiveness data
to inform
resources allocation decisions in healthcare.  A brief outline of the
project is given below.

The studentship will be under the supervision of Dr Andrea Manca (Senior
Research Fellow in Health Economics, Centre for Health Economics, University
of York) and Dr Alex Sutton (Reader in Medical Statistics, Centre for
Biostatistics and Genetic Epidemiology, Department of Health Sciences,
University of Leicester). 

For informal enquiries and further details please contact Dr Andrea Manca
([log in to unmask]).   

The successful applicant should have a strong quantitative (e.g.
mathematics, statistics, operational research, econometrics) background and
an interest in developing statistical methodology in the area of healthcare
cost‑effectiveness analysis.  Some knowledge of economics is desirable but
not essential.

This is an MRC award and the MRC eligibility criteria apply.  Full details
about eligibility criteria are available here.   

Applicants should send a statement of interest (no more than 1 page) and a
CV with the names and contact details of two academic referees to Dr Andrea
Manca ([log in to unmask]) by Wednesday 23rd April 2008.

Project Outline
In response to the financial pressure under which most healthcare systems
currently operate, many countries have now introduced a formal assessment
process to establish whether health technologies are ‘value for money’. 
Cost‑effectiveness analysis (CEA) provides a technical tool to inform the
above question.  The National Institute for Health and Clinical Excellence
(NICE) is an example of an agency which requires consideration of clinical
and cost‑effectiveness evidence as the basis for issuing recommendations
regarding the use of specific health technologies in the National Healthcare
System (NHS) for England and Wales.

Healthcare CEA has been traditionally conducted adopting two different
methodological approaches. The first involves the use of individual
patient‑level data (IPD) collected alongside randomised controlled trials
(RCTs). The second approach uses decision‑analytic modelling (DAM). The
latter is a framework within which evidence, typically available in the form
of aggregate level data (ALD) ‑ e.g. number of events, individuals at
risk,
contacts with healthcare providers ‑ is combined and arranged to address a
clearly specified decision problem.  While both DAM and RCT-based CEA are
extensively used in applied research, it has recently been argued that RCTs
may be neither sufficient nor the most efficient vehicle to produce
information that can directly feed into the decision‑making process in
healthcare.

The proposed project will involve an exploration of a set of methodological
issues relating to the analysis of individual and aggregate patient‑level
data for CEA.  The research questions addressed by the PhD will depend on
both the student research interests and the status of the literature at the
time of the start of the PhD, but it is expected that they will include one
or more of the following themes:

(i) the statistical analysis of individual patient‑level data from a
single
trial to generate parameters needed to populate decision-analytic
cost‑effectiveness models;

(ii) the development of statistical modelling methods using
cost‑effectiveness data derived from one country to inform decisions in
another, where the latter did not participate in the original clinical trial;

(iii) the development of statistical methods to accommodate the simultaneous
analysis of individual patient and aggregate‑level data for CEA purposes.

The Research Environment
The student will work in the Team for Economic Evaluation and Health
Technology Assessment (TEEHTA), which is part of one the various research
programs operating within CHE.  Established in 1983, the Centre has a
leading international reputation, and is now one of the world’s largest
health economics research units, employing about 40 researchers and having
associations with at least 200 academics forming the broader community of
health economics specialists at the University of York. CHE attaches high
importance to scientific quality, and its researchers play a leading role in
the national and international arena.  In the 2001 UK Research Assessment
Exercise, CHE staff were entered into three Units of Assessment at the
University of York, all of which achieved a rating of 5, signalling work of
international excellence.  The health economics component of the Economics
Unit of Assessment was singled out as excellent. 

CHE engages in a variety of teaching activities. Its researchers contribute
to the long-standing MSc program in health economics at York and to MSc
courses in the Department of Health Sciences. CHE plays a leading role in
the York distance learning courses in Health Economics, and has a vibrant
PhD program.  CHE delivers specialist expert workshops in a variety of
fields, including economic evaluation, health technology assessment,
econometric methods and efficiency measurement.  All of which will be
accessible to the student.

CHE is at the centre of a large network of health service researchers
including the Centre for Reviews and Dissemination, the Department of
Economics and Related Studies, Hull York Medical School, York Health
Economics Consortium and the National Primary Care Research and Development
Centre based at the Universities of Manchester and York.  The health-related
research and teaching activity in York encompasses a large network of
research and support staff with a community of around 200 health service
researchers.  Further details of CHE’s activities can be found on our web
site: http://www.york.ac.uk/inst/che

The University of York is widely recognised as one of the leading research
universities in the UK.  In the 2001 Research Assessment Exercise carried
out by the Higher Education Funding Council for England, 18 out of 23
departments were awarded the top scores of 5 or 5*. 

The supervisors
This project offers a unique opportunity to develop cutting edge statistical
methods for economic evaluation applied to health policy decisions, while
working in close contact with researchers in two very successful research
groups in the UK.   While being based at CHE in York, working under the main
supervision of Dr Andrea Manca - a health economist - the successful
applicant will have expert statistical from Dr Alex Sutton (2nd supervisor)
- a medical statistician based in the Department of Health Sciences at the
University of Leicester.