Validation of a decision support model for investigation and improvement in stroke thrombolysis

Validation of Operations Research/Management Science (OR/MS) decision support models is usually performed with the aim of providing the decision makers with sufficient confidence to utilize the model's recommendations to support their decision-making. OR/MS models for investigation and improvement provide a particularly challenging task as far as validation is concerned. Their complex nature often relies on a wide variety of data sources and empirical estimates used as parameters in the model, as well as on multiple conceptual and computational modeling techniques. In this paper, we performed an extensive literature review of validation techniques for healthcare models in OR/MS. Despite calls for systematic approaches to validation of complex OR/MS decision support models; we identified a clear lack of appropriate application of validation techniques reported in published healthcare models. The "Save a minute - save a day" model for evaluation of long-term benefits of faster access to thrombolysis therapy in acute ischemic stroke is used as a case to demonstrate how multiple aspects of data validity, conceptual model validity, computerized verification, and operational model validity can be systematically addressed when developing a complex OR/MS decision support model for investigation and improvement in health services.