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An Introductory Tutorial on Cohort State-Transition Models in R Using a Cost-Effectiveness Analysis Example

Applications 2022-09-20 v4 Quantitative Methods Computation

Abstract

Decision models can combine information from different sources to simulate the long-term consequences of alternative strategies in the presence of uncertainty. A cohort state-transition model (cSTM) is a decision model commonly used in medical decision-making to simulate the transitions of a hypothetical cohort among various health states over time. This tutorial focuses on time-independent cSTM, where transition probabilities among health states remain constant over time. We implement time-independent cSTM in R, an open-source mathematical and statistical programming language. We illustrate time-independent cSTMs using a previously published decision model, calculate costs and effectiveness outcomes, conduct a cost-effectiveness analysis of multiple strategies, including a probabilistic sensitivity analysis. We provide open-source code in R to facilitate wider adoption. In a second, more advanced tutorial, we illustrate time-dependent cSTMs.

Keywords

Cite

@article{arxiv.2001.07824,
  title  = {An Introductory Tutorial on Cohort State-Transition Models in R Using a Cost-Effectiveness Analysis Example},
  author = {Fernando Alarid-Escudero and Eline M. Krijkamp and Eva A. Enns and Alan Yang and M. G. Myriam Hunink and Petros Pechlivanoglou and Hawre Jalal},
  journal= {arXiv preprint arXiv:2001.07824},
  year   = {2022}
}

Comments

Tutorial with 30 pages, 6 tables and 6 figures. For R code, see https://github.com/DARTH-git/cohort-modeling-tutorial-intro

R2 v1 2026-06-23T13:17:12.463Z