In five e-mail rounds, HE experts commented on the initial list and drafts of AdViSHE. The setup of these rounds was based on the Delphi method, a structured communication technique in which experts answer questions in two or more rounds. The key element is that experts are encouraged to revise their earlier answers in light of the replies of other members of their panel in order to reach consensus [13 –15 ]. The design of each round was not fixed beforehand, but was based on the outcomes of the previous round. A summary of the commentary from previous rounds was provided and every participant was actively encouraged to comment and provide suggestions for additions; all experts were allowed to refine or change their opinion. Steps were taken to include a wide variety of nationalities, work environments, and expertise (Table 1). In between rounds, new experts were approached to enhance international diversity and to counter attrition.

Source of contact information of health-economic experts

SourceNumber of experts contacted
Personal network of the project team129
Proposed replacements by invitees10
Involved in the ISPOR-SMDM Good Modeling Practices Task Force31
Authors of the CHEERS statement [11 (link)]6
Involved in the organizing committee of at least one of the ISPOR conferences (International, European, Asia–Pacific, and Latin America) between 2008 and 2014140
Involved in the ISPOR regional chapters100
Identified by other experts19
Identified by biomedexperts.com as experts in “Economic Models” and/or “Markov Chains”35

CHEERS Consolidated Health Economic Evaluation Reporting Standards, ISPOR International Society For Pharmacoeconomics and Outcomes Research, SMDM Society for Medical Decision making

Comments on an early draft of AdViSHE were solicited from employees of Zorginstituut Nederland (the Dutch Healthcare Institute), the primary advisory council for the Dutch Ministry of Health regarding reimbursement. Zorginstituut Nederland is representative of the field of policy decision makers for whom AdViSHE might be useful.
A conference workshop was organized in Montreal, Canada, where attendees discussed the first full draft of the tool amongst themselves. Three of the authors (PV, GVV, ICR) actively approached groups of discussants. All participants were encouraged to comment using a questionnaire. All comments made during this workshop were collected and incorporated in the final draft, which was sent out to the Delphi panel in a final round of comments. It was then edited for language, after which the project group agreed on the final version of AdViSHE.