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Professor Anne Spencer

Professor Anne Spencer

Associate Professor

6441

Anne Spencer joined the Health Economics Group at the University of Exeter in January 2012. Formerly she worked for 12 years as a Lecturer and Senior Lecturer in the School of Economics and Finance, at Queen Mary University of London.

Anne studied Economics at St Andrews University (BSc 1987) and Oxford University (M.Phil 1989). She developed an interest in Health Economics during her two years as an Overseas Development Institute Fellow in the Ministry of Health in Lesotho, Southern Africa. This was followed by a research fellowship in Economics at York University, during which she completed a Ph.D under the supervision of Graham Loomes. Her Ph.D investigated the methods commonly used to elicit preferences for risky treatments.

A common theme of her work is towards developing methodology of health economic evaluation and preference elicitation as well as leading the primary economic evaluation of trails. She has become known for her research around decision making and ‘states worse than dead’ and the methodology around preference elicitation. She also works on research that aims to increase our understandings of medical decision making under risk, ambiguity and time.

More recently she has become interested in the use of choice based methods to elicit preferences. Discrete choice experiments (DCEs) allow a number of characteristics to be traded off against one another and are becoming increasingly popular in health economics. The DCE approach has helped to address some methodological problems faced by more traditional techniques and has raised new challenges. Her research explores the methods used to value QALYs within a DCE, and explores the challenges that these methods face.

Other areas of interest include the application of models to evaluate competing confirmations of services.  Examples of her work in this area include applications of models to domestic violence and the configuration of neonatal services.  As part of these applications Anne has experience in developing models alongside clinical trials, from pilot to main trial. This work has helped to highlight the usefulness of developing a pilot model and shows how the economic model can be further refined in the light of new external data sources.

Anne is a member of the South West Research for Patient Benefit (RfPB) Regional Advisory Committee and the Medical Research Council Skills Development Panel.

 

 

Research

Research interests

Anne's works on improving the methods to inform policy makers including: - Applying behavioural models to predict patient choice - Applying decision analytic models to forecast the longer term impacts of trials - Measurement and valuation of patient reported health outcomes - Health service research design and implementation of economic evaluations alongside trails - Investigation of methods to calculate the Value of Statistical Life She is also the lead researcher for the health economics analysis of a number of large trials including exercise interventions (OPERA), domestic violence (IRIS and PREDOVE) and knee pain (TOIB).

Key publications | Publications by category | Publications by year

Key publications


Robinson A, Spencer AE, Pinto-Prades JL, Covey JA (2016). Exploring Differences between TTO and DCE in the Valuation of Health States. Medical decision making : an international journal of the Society for Medical Decision Making Abstract.  Full text.
Robinson A, Spencer A, Moffatt P (2015). A framework for estimating health state utility values within a discrete choice experiment: modeling risky choices. Med Decis Making, 35(3), 341-350. Abstract.  Author URL.  Full text.
Allen M, Spencer A, Gibson A, Matthews J, Allwood A, Prosser S, Pitt M, Spencer AE (2015). Right cot, right place, right time: improving the design and organisation of neonatal care networks. Health service delivery research, 3(20). Full text.
Devine A, Taylor SJC, Spencer A, Diaz-Ordaz K, Eldridge S, Underwood M (2014). The agreement between proxy and self-completed EQ-5D for care home residents was better for index scores than individual domains. J Clin Epidemiol, 67(9), 1035-1043. Abstract.  Author URL.  Full text.
Underwood M, Lamb SE, Eldridge S, Sheehan B, Slowther A-M, Spencer A, Thorogood M, Atherton N, Bremner SA, Devine A, et al (2013). Exercise for depression in elderly residents of care homes: a cluster-randomised controlled trial. The Lancet
Spencer AE (2012). Cost effectiveness of a system level intervention to improve the primary health care response to intimate partner violence. Journal of Health Services Research and Policy

Publications by category


Books

Morris S, Devlin N, Parkin D, Spencer A (2012). Economic Analysis in Healthcare., Wiley. Abstract.

Journal articles

Dean S, Poltawski L, Forster A, Taylor R, Spencer A, James M, Allison R, Stevens S, Norris M, Shepherd A, et al (In Press). Community-based Rehabilitation Training after stroke: protocol of a pilot randomised controlled trial (ReTrain). BMJ Open Full text.
Robinson A, Spencer AE, Pinto-Prades JL, Covey JA (2016). Exploring Differences between TTO and DCE in the Valuation of Health States. Medical decision making : an international journal of the Society for Medical Decision Making Abstract.  Full text.
Taylor SJC, Carnes D, Homer K, Pincus T, Kahan BC, Hounsome N, Eldridge S, Spencer A, Diaz-Ordaz K, Rahman A, et al (2016). Improving the self-management of chronic pain: COping with persistent Pain, Effectiveness Research in Self-management (COPERS). Programme Grants for Applied Research, 4(14), 1-440. Full text.
Taylor SJC, Carnes D, Homer K, Kahan BC, Hounsome N, Eldridge S, Spencer A, Pincus T, Rahman A, Underwood M, et al (2016). Novel Three-Day, Community-Based, Nonpharmacological Group Intervention for Chronic Musculoskeletal Pain (COPERS): a Randomised Clinical Trial. PLoS Med, 13(6). Abstract.  Author URL.  Full text.
White MP, Elliott LR, Taylor TJ, Wheeler BW, Spencer AE, Bone A, Depledge MH, Fleming LE (2016). Recreational physical activity in natural environments and implications for health: a population based cross-sectional study in England. Preventative Medicine Full text.
Papathanasopoulou E, White MP, Hattam C, Lannin A, Harvey A, Spencer A (2016). Valuing the health benefits of physical activities in the marine environment and their importance for marine spatial planning. Marine Policy, 63, 144-152. Abstract.  Full text.
Robinson A, Spencer A, Moffatt P (2015). A framework for estimating health state utility values within a discrete choice experiment: modeling risky choices. Med Decis Making, 35(3), 341-350. Abstract.  Author URL.  Full text.
Goodwin E, Green C, Spencer A (2015). Estimating a Preference-Based Index for an Eight-Dimensional Health State Classification System for Multiple Sclerosis. Value Health, 18(8), 1025-1036. Abstract.  Author URL.  Full text.
Chilton S, Covey J, Jones-Lee M, Loomes G, Pidgeon N, Spencer A (2015). Response to 'Testing the validity of the "value of a prevented fatality" (VPF) used to assess UK safety measures'. PROCESS SAFETY AND ENVIRONMENTAL PROTECTION, 93, 293-298. Author URL.  Full text.
Allen M, Spencer A, Gibson A, Matthews J, Allwood A, Prosser S, Pitt M, Spencer AE (2015). Right cot, right place, right time: improving the design and organisation of neonatal care networks. Health service delivery research, 3(20). Full text.
Devine A, Taylor SJC, Spencer A, Diaz-Ordaz K, Eldridge S, Underwood M (2014). The agreement between proxy and self-completed EQ-5D for care home residents was better for index scores than individual domains. J Clin Epidemiol, 67(9), 1035-1043. Abstract.  Author URL.  Full text.
Underwood M, Lamb SE, Eldridge S, Sheehan B, Slowther A, Spencer AE, Thorogood M, Atherton N, Bremner SA, Devine A, et al (2013). Exercise for depression in care home residents: a randomised controlled trial with cost-effectiveness analysis (OPERA). Health Technol Assess, 17(18), 1-1. Full text.
Underwood M, Lamb SE, Eldridge S, Sheehan B, Slowther A-M, Spencer A, Thorogood M, Atherton N, Bremner SA, Devine A, et al (2013). Exercise for depression in elderly residents of care homes: a cluster-randomised controlled trial. The Lancet
Spencer AE (2012). Cost effectiveness of a system level intervention to improve the primary health care response to intimate partner violence. Journal of Health Services Research and Policy
Devine A, Spencer A, Eldridge S, Norman R, Feder G (2012). Cost-effectiveness of Identification and Referral to Improve Safety (IRIS), a domestic violence training and support programme for primary care: a modelling study based on a randomised controlled trial. BMJ Open, 2(3). Abstract.  Author URL.  Full text.
Taylor SJC, Bremner SA, Choudhury A, Cook V, Devine A, Eldridge S, Feder G, Foster G, Islam K, Sohanpal R, et al (2011). OEDIPUS: a CLUSTER RANDOMISED TRIAL OF EDUCATION FOR SOUTH ASIANS WITH ASTHMA, AND THEIR PRIMARY AND SECONDARY CARE PHYSICIANS, TO REDUCE UNSCHEDULED CARE. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 65, A13-A13. Author URL.
Spencer AE, Robinson, Covey, Loomes (2010). Are some deaths worse than others ? the effect of labelling on peoples perceptions. Journal of Economic Psychology
Norman R, Spencer A, Eldridge S, Feder G (2010). Cost-effectiveness of a programme to detect and provide better care for female victims of intimate partner violence. Journal of Health Services Research and Policy, 15(3), 143-149. Abstract.
Feder G, Ramsay J, Dunne D, Rose M, Arsene C, Norman R, Kuntze S, Spencer A, Bacchus L, Hague G, et al (2009). How far does screening women for domestic (partner) violence in different health-care settings meet criteria for a screening programme? Systematic reviews of nine UK National Screening Committee criteria. HEALTH TECHNOLOGY ASSESSMENT, 13(16), 1-+. Author URL.  Full text.
Spencer AE, Castelnuovo, Underwood (2008). Cost-effectiveness of advising the use of topical or oral ibruprofen for knee pain. Rheumatology
Castelnuovo E, Cross P, Mt-Isa S, Spencer A, Underwood M, TOIB study team (2008). Cost-effectiveness of advising the use of topical or oral ibuprofen for knee pain; the TOIB study [ISRCTN: 79353052]. Rheumatology (Oxford), 47(7), 1077-1081. Abstract.  Author URL.
Underwood M, Ashby D, Carnes D, Castelnuovo E, Cross P, Harding G, Hennessy E, Letley L, Martin J, Mt-Isa S, et al (2008). Topical or oral ibuprofen for chronic knee pain in older people. The TOIB study. Health Technol Assess, 12(22), iii-155. Abstract.  Author URL.  Full text.
Spencer A, Robinson A (2007). Tests of utility independence when health varies over time. J Health Econ, 26(5), 1003-1013. Abstract.  Author URL.
Underwood MR, Parsons S, Eldridge SM, Spencer AE, Feder GS (2006). Asking older people about fear of falling did not have a negative effect. J Clin Epidemiol, 59(6), 629-634. Abstract.  Author URL.
Robinson A, Spencer A (2006). Exploring challenges to TTO utilities: valuing states worse than dead. HEALTH ECONOMICS, 15(4), 393-402. Author URL.
Towers I, Spencer A, Brazier J (2005). Healthy year equivalents versus quality-adjusted life years: the debate continues. Expert Review of Pharmacoeconomics and Outcomes Research, 5(3), 245-254. Abstract.
Cross PL, Ashby D, Harding G, Hennessy EM, Letley L, Parsons S, Spencer AE, Underwood M, TOIB Study Team (2005). TOIB Study. Are topical or oral ibuprofen equally effective for the treatment of chronic knee pain presenting in primary care: a randomised controlled trial with patient preference study. [ISRCTN79353052]. BMC Musculoskelet Disord, 6 Abstract.  Author URL.  Full text.
Spencer A, Covey J, Chilton S, Taylor M (2005). Testing the internal consistency of the lottery equivalents method using health outcomes: a comment to Oliver. Health Econ, 14(2), 161-167. Author URL.
Eldridge S, Spencer A, Cryer C, Parsons S, Underwood M, Feder G (2005). Why modelling a complex intervention is an important precursor to trial design: lessons from studying an intervention to reduce falls-related injuries in older people. J Health Serv Res Policy, 10(3), 133-142. Abstract.  Author URL.
Spencer A (2004). The implications of linking questions within the SG and TTO methods. Health Econ, 13(8), 807-818. Abstract.  Author URL.
Spencer A (2003). A test of the QALY model when health varies over time. Soc Sci Med, 57(9), 1697-1706. Abstract.  Author URL.
Spencer A (2003). The TTO method and procedural invariance. Health Econ, 12(8), 655-668. Abstract.  Author URL.
Chilton S, Covey J, Hopkins L, Jones-Lee M, Loomes G, Pidgeon N, Spencer A (2002). Public perceptions of risk and preference-based values of safety. JOURNAL OF RISK AND UNCERTAINTY, 25(3), 211-232. Author URL.
Chilton S, Spencer AE (2001). Empirical evidence of inconsistency in Standard Gamble choices under direct and indirect elicitation methods. Swiss J Economics, 137, 65-65.
Carthy T, Chilton S, Covey J, Hopkins L, Jones-Lee M, Pidgeon N, Spencer AE (1999). On the Contingent Valuation of Safety and the Safety of Contingent Valuation: Part 2 - the CV/SG "Chained" Approach. J Risk Uncertainty, 17, 187-213.
Newbold KB, Eyles J, Birch S, Spencer A (1998). Allocating resources in health care: alternative approaches to measuring needs in resource allocation formula in Ontario. Health & Place, 4(1), 79-89.
Torgerson DJ, Spencer A (1996). Marginal costs and benefits. BMJ, 312(7022), 35-36.
Torgerson DJ, Spencer A (1996). Methods used in economic evaluations of prenatal screening are disputed. BMJ, 313(7052), 303-303.

Reports

Feder G, Ramsay J, Spencer AE, Hague G (2005). PREvention of DOmestic ViolencE: a pilot study in primary care (PREDOVE).  Nuffield Foundation Report.

Publications by year


In Press

Dean S, Poltawski L, Forster A, Taylor R, Spencer A, James M, Allison R, Stevens S, Norris M, Shepherd A, et al (In Press). Community-based Rehabilitation Training after stroke: protocol of a pilot randomised controlled trial (ReTrain). BMJ Open Full text.

2016

Robinson A, Spencer AE, Pinto-Prades JL, Covey JA (2016). Exploring Differences between TTO and DCE in the Valuation of Health States. Medical decision making : an international journal of the Society for Medical Decision Making Abstract.  Full text.
Taylor SJC, Carnes D, Homer K, Pincus T, Kahan BC, Hounsome N, Eldridge S, Spencer A, Diaz-Ordaz K, Rahman A, et al (2016). Improving the self-management of chronic pain: COping with persistent Pain, Effectiveness Research in Self-management (COPERS). Programme Grants for Applied Research, 4(14), 1-440. Full text.
Taylor SJC, Carnes D, Homer K, Kahan BC, Hounsome N, Eldridge S, Spencer A, Pincus T, Rahman A, Underwood M, et al (2016). Novel Three-Day, Community-Based, Nonpharmacological Group Intervention for Chronic Musculoskeletal Pain (COPERS): a Randomised Clinical Trial. PLoS Med, 13(6). Abstract.  Author URL.  Full text.
White MP, Elliott LR, Taylor TJ, Wheeler BW, Spencer AE, Bone A, Depledge MH, Fleming LE (2016). Recreational physical activity in natural environments and implications for health: a population based cross-sectional study in England. Preventative Medicine Full text.
Papathanasopoulou E, White MP, Hattam C, Lannin A, Harvey A, Spencer A (2016). Valuing the health benefits of physical activities in the marine environment and their importance for marine spatial planning. Marine Policy, 63, 144-152. Abstract.  Full text.

2015

Robinson A, Spencer A, Moffatt P (2015). A framework for estimating health state utility values within a discrete choice experiment: modeling risky choices. Med Decis Making, 35(3), 341-350. Abstract.  Author URL.  Full text.
Goodwin E, Green C, Spencer A (2015). Estimating a Preference-Based Index for an Eight-Dimensional Health State Classification System for Multiple Sclerosis. Value Health, 18(8), 1025-1036. Abstract.  Author URL.  Full text.
Chilton S, Covey J, Jones-Lee M, Loomes G, Pidgeon N, Spencer A (2015). Response to 'Testing the validity of the "value of a prevented fatality" (VPF) used to assess UK safety measures'. PROCESS SAFETY AND ENVIRONMENTAL PROTECTION, 93, 293-298. Author URL.  Full text.
Allen M, Spencer A, Gibson A, Matthews J, Allwood A, Prosser S, Pitt M, Spencer AE (2015). Right cot, right place, right time: improving the design and organisation of neonatal care networks. Health service delivery research, 3(20). Full text.

2014

Devine A, Taylor SJC, Spencer A, Diaz-Ordaz K, Eldridge S, Underwood M (2014). The agreement between proxy and self-completed EQ-5D for care home residents was better for index scores than individual domains. J Clin Epidemiol, 67(9), 1035-1043. Abstract.  Author URL.  Full text.

2013

Underwood M, Lamb SE, Eldridge S, Sheehan B, Slowther A, Spencer AE, Thorogood M, Atherton N, Bremner SA, Devine A, et al (2013). Exercise for depression in care home residents: a randomised controlled trial with cost-effectiveness analysis (OPERA). Health Technol Assess, 17(18), 1-1. Full text.
Underwood M, Lamb SE, Eldridge S, Sheehan B, Slowther A-M, Spencer A, Thorogood M, Atherton N, Bremner SA, Devine A, et al (2013). Exercise for depression in elderly residents of care homes: a cluster-randomised controlled trial. The Lancet

2012

Spencer AE (2012). Cost effectiveness of a system level intervention to improve the primary health care response to intimate partner violence. Journal of Health Services Research and Policy
Devine A, Spencer A, Eldridge S, Norman R, Feder G (2012). Cost-effectiveness of Identification and Referral to Improve Safety (IRIS), a domestic violence training and support programme for primary care: a modelling study based on a randomised controlled trial. BMJ Open, 2(3). Abstract.  Author URL.  Full text.
Morris S, Devlin N, Parkin D, Spencer A (2012). Economic Analysis in Healthcare., Wiley. Abstract.

2011

Taylor SJC, Bremner SA, Choudhury A, Cook V, Devine A, Eldridge S, Feder G, Foster G, Islam K, Sohanpal R, et al (2011). OEDIPUS: a CLUSTER RANDOMISED TRIAL OF EDUCATION FOR SOUTH ASIANS WITH ASTHMA, AND THEIR PRIMARY AND SECONDARY CARE PHYSICIANS, TO REDUCE UNSCHEDULED CARE. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 65, A13-A13. Author URL.

2010

Spencer AE, Robinson, Covey, Loomes (2010). Are some deaths worse than others ? the effect of labelling on peoples perceptions. Journal of Economic Psychology
Norman R, Spencer A, Eldridge S, Feder G (2010). Cost-effectiveness of a programme to detect and provide better care for female victims of intimate partner violence. Journal of Health Services Research and Policy, 15(3), 143-149. Abstract.

2009

Feder G, Ramsay J, Dunne D, Rose M, Arsene C, Norman R, Kuntze S, Spencer A, Bacchus L, Hague G, et al (2009). How far does screening women for domestic (partner) violence in different health-care settings meet criteria for a screening programme? Systematic reviews of nine UK National Screening Committee criteria. HEALTH TECHNOLOGY ASSESSMENT, 13(16), 1-+. Author URL.  Full text.

2008

Spencer AE, Castelnuovo, Underwood (2008). Cost-effectiveness of advising the use of topical or oral ibruprofen for knee pain. Rheumatology
Castelnuovo E, Cross P, Mt-Isa S, Spencer A, Underwood M, TOIB study team (2008). Cost-effectiveness of advising the use of topical or oral ibuprofen for knee pain; the TOIB study [ISRCTN: 79353052]. Rheumatology (Oxford), 47(7), 1077-1081. Abstract.  Author URL.
Underwood M, Ashby D, Carnes D, Castelnuovo E, Cross P, Harding G, Hennessy E, Letley L, Martin J, Mt-Isa S, et al (2008). Topical or oral ibuprofen for chronic knee pain in older people. The TOIB study. Health Technol Assess, 12(22), iii-155. Abstract.  Author URL.  Full text.

2007

Spencer A, Robinson A (2007). Tests of utility independence when health varies over time. J Health Econ, 26(5), 1003-1013. Abstract.  Author URL.

2006

Underwood MR, Parsons S, Eldridge SM, Spencer AE, Feder GS (2006). Asking older people about fear of falling did not have a negative effect. J Clin Epidemiol, 59(6), 629-634. Abstract.  Author URL.
Robinson A, Spencer A (2006). Exploring challenges to TTO utilities: valuing states worse than dead. HEALTH ECONOMICS, 15(4), 393-402. Author URL.

2005

Towers I, Spencer A, Brazier J (2005). Healthy year equivalents versus quality-adjusted life years: the debate continues. Expert Review of Pharmacoeconomics and Outcomes Research, 5(3), 245-254. Abstract.
Feder G, Ramsay J, Spencer AE, Hague G (2005). PREvention of DOmestic ViolencE: a pilot study in primary care (PREDOVE).  Nuffield Foundation Report.
Cross PL, Ashby D, Harding G, Hennessy EM, Letley L, Parsons S, Spencer AE, Underwood M, TOIB Study Team (2005). TOIB Study. Are topical or oral ibuprofen equally effective for the treatment of chronic knee pain presenting in primary care: a randomised controlled trial with patient preference study. [ISRCTN79353052]. BMC Musculoskelet Disord, 6 Abstract.  Author URL.  Full text.
Spencer A, Covey J, Chilton S, Taylor M (2005). Testing the internal consistency of the lottery equivalents method using health outcomes: a comment to Oliver. Health Econ, 14(2), 161-167. Author URL.
Eldridge S, Spencer A, Cryer C, Parsons S, Underwood M, Feder G (2005). Why modelling a complex intervention is an important precursor to trial design: lessons from studying an intervention to reduce falls-related injuries in older people. J Health Serv Res Policy, 10(3), 133-142. Abstract.  Author URL.

2004

Spencer A (2004). The implications of linking questions within the SG and TTO methods. Health Econ, 13(8), 807-818. Abstract.  Author URL.

2003

Spencer A (2003). A test of the QALY model when health varies over time. Soc Sci Med, 57(9), 1697-1706. Abstract.  Author URL.
Spencer A (2003). The TTO method and procedural invariance. Health Econ, 12(8), 655-668. Abstract.  Author URL.

2002

Chilton S, Covey J, Hopkins L, Jones-Lee M, Loomes G, Pidgeon N, Spencer A (2002). Public perceptions of risk and preference-based values of safety. JOURNAL OF RISK AND UNCERTAINTY, 25(3), 211-232. Author URL.

2001

Chilton S, Spencer AE (2001). Empirical evidence of inconsistency in Standard Gamble choices under direct and indirect elicitation methods. Swiss J Economics, 137, 65-65.

1999

Carthy T, Chilton S, Covey J, Hopkins L, Jones-Lee M, Pidgeon N, Spencer AE (1999). On the Contingent Valuation of Safety and the Safety of Contingent Valuation: Part 2 - the CV/SG "Chained" Approach. J Risk Uncertainty, 17, 187-213.

1998

Newbold KB, Eyles J, Birch S, Spencer A (1998). Allocating resources in health care: alternative approaches to measuring needs in resource allocation formula in Ontario. Health & Place, 4(1), 79-89.

1996

Torgerson DJ, Spencer A (1996). Marginal costs and benefits. BMJ, 312(7022), 35-36.
Torgerson DJ, Spencer A (1996). Methods used in economic evaluations of prenatal screening are disputed. BMJ, 313(7052), 303-303.

Anne has taught extensively during her 12 years at the School of Economics and Finance at Queen Mary, University of London. Teaching first year Microeconomics and third year Health Economics.

She is the co-author on a second edition of the book ‘Economic Analysis in Health Care’, in collaboration with Stephen Morris, Nancy Devlin and David Parkin. The text book is intended as a core textbook for advanced undergraduate and postgraduate students of health economics and provides comprehensive coverage of the field of economics in health care and the evaluation of health care technologies. This edition has been fully revised with up-to-date case studies from the UK, Europe and the Rest of the World.  It includes a new chapter on health care labour markets and contains new material integrated throughout the text on the economics of public health. The exercises on the website for the book draw heavily upon Anne’s experience of integration Health Economics more formally within an Economics Department and uses algebraic examples to illustrate the key issues addressed by Health Economics.

Economic Analysis in Healthcare, S Morris, N Devlin, D Parkin, A Spencer John Wiley & Sons 2012, ISBN: 978-1119951490

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