Incorporating Bayesian ideas into health-care evaluation

We argue that the Bayesian approach is best seen as providing additional tools for those carrying out health-care evaluations, rather than replacing their traditional methods. A distinction is made between those features that arise from the basic Bayesian philosophy and those that come from the modem ability to make inferences using very complex models. Selected examples of the former include explicit recognition of the wide cast of stakeholders in any evaluation, simple use of Bayes theorem and use of a community of prior distributions. In the context of complex models, we selectively focus on the possible role of simple Monte Carlo methods, alternative structural models for incorporating historical data and making inferences on complex functions of indirectly estimated parameters. These selected issues are illustrated by two worked examples presented in a standardized format. The emphasis throughout is on inference rather than decision-making.