Statistical Modeling & Health Economics
Honours thesis · expected April 2027
Cost-Effectiveness of the JAKPOT Rule
When is a genetic test worth ordering at all? A decision-analytic model comparing a clinical rule that selects which patients receive JAK2 mutation testing against testing everyone referred for erythrocytosis in Ontario, with parameter uncertainty carried through to the result rather than reported as a single number.
Overview
When is a genetic test worth ordering at all? This honours thesis (MBI 4985E, Western University) builds a decision-analytic model comparing a clinical rule — the JAKPOT rule, which selects which patients referred for erythrocytosis receive JAK2 mutation testing — against simply testing everyone referred in Ontario.
Parameter uncertainty is carried through to the result rather than reported as a single number. The work is supervised by Dr. Lauren Cipriano and Dr. Benjamin Chin-Yee.
The question
A JAK2 mutation test adds cost and only sometimes changes what happens next. The JAKPOT rule is a proposal for which patients referred for erythrocytosis should be tested — but whether selecting patients with the rule is cost-effective compared to testing everyone referred in the Ontario pathway is an open, quantitative question. That is what the model is built to answer.
Model structure & approach
- 01
Compared a selection rule against testing everyone
The model sets the JAKPOT clinical rule, which chooses who receives JAK2 testing, against a strategy of testing every patient referred for erythrocytosis in Ontario.
- 02
Framed it as a cost-effectiveness decision
The strategies are compared on cost and health outcomes, rather than on diagnostic performance alone.
- 03
Carried parameter uncertainty throughout
Inputs are specified as distributions rather than fixed values, so the conclusion reflects how much is actually known rather than a single point estimate.
- 04
Built in sensitivity analysis
Probabilistic sensitivity and value-of-information style analyses are designed in to show which uncertainties move the decision and which do not.
“Results are being withheld until the thesis is defended and my supervisors have signed off.”