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Confidence Interval

A range of values, calculated from sample data, expected to contain the true population parameter with a specified level of confidence.

Last reviewedDarrin Baines IP Ltd

Concept Architecture

Concept

Theoretically, a Confidence Interval is an interval estimate that provides a range of plausible values for an unknown population parameter based on sample data and a specified confidence level. It is founded on frequentist statistical inference and sampling theory, where repeated sampling from the same population would produce intervals that contain the true parameter with a known long-run frequency. In health economics, confidence intervals quantify statistical uncertainty surrounding estimates of treatment effects, costs, utilities, quality-adjusted life years and incremental cost-effectiveness measures.

Mathematically, a confidence interval is constructed by combining a point estimate with a margin of error determined by the sampling distribution of the estimator and the desired confidence level. Under normality or large-sample conditions, the interval is calculated using a critical value from the standard normal or Student's t-distribution multiplied by the estimator's standard error. The interval reflects sampling uncertainty rather than the probability that the parameter lies within a particular observed interval.

In practice, confidence intervals are calculated alongside point estimates in clinical trials, observational studies, regression analyses and economic evaluations. They are routinely reported to quantify estimation precision, assess statistical significance and support healthcare decision-making by indicating the range of values compatible with the observed evidence.


Purpose

Used to quantify uncertainty surrounding parameter estimates, assess estimation precision, support statistical inference, compare treatment effects and inform decision-making in health economic evaluation.


Mathematical Formulae

Primary Formula

CI = ?? � z??�?? ? SE(??)

Supporting Formulae

95% CI = ?? � 1.96 ? SE(??)

CI = ?? � t??�??,df ? SE(??)

Margin of Error = Critical Value ? SE(??)

Related Mathematical Methods

Standard Error

Hypothesis Testing

Central Limit Theorem

Student's t-Distribution

Maximum Likelihood Estimation

Bootstrap Confidence Interval

Bayesian Credible Interval


Example

A health economist estimates the mean annual healthcare cost associated with a new intervention.

Estimated mean cost = �4,850

Standard error = �120

Using a 95% confidence level:

95% CI = 4,850 � (1.96 ? 120)

95% CI = 4,850 � 235.2

95% CI = (�4,614.80, �5,085.20)

The interval indicates the range of plausible values for the population mean cost based on the observed sample.


Excel Implementation

FunctionExample FormulaHealth Economics Application
AVERAGE=AVERAGE(B2:B101)Calculate point estimate
STDEV.S=STDEV.S(B2:B101)Estimate sample standard deviation
COUNT=COUNT(B2:B101)Determine sample size
SQRT=SQRT(COUNT(B2:B101))Calculate �n for the standard error
CONFIDENCE.NORM=CONFIDENCE.NORM(0.05,STDEV.S(B2:B101),COUNT(B2:B101))Calculate normal-theory confidence interval margin
CONFIDENCE.T=CONFIDENCE.T(0.05,STDEV.S(B2:B101),COUNT(B2:B101))Calculate t-based confidence interval margin

VBA (Optional)

Automate calculation and reporting of confidence intervals for multiple model parameters and clinical outcomes across health economic analyses.


Sources

Altman DG. Practical Statistics for Medical Research.

Casella G, Berger RL. Statistical Inference.

Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the Economic Evaluation of Health Care Programmes.

Briggs A, Claxton K, Sculpher M. Decision Modelling for Health Economic Evaluation.

NICE. Health Technology Evaluation Manual.

CHEERS 2022 Statement.

Library

Publications

1
  • Book

    Bayesian Methods in Health Economics — Gianluca Baio, 1st Edition ed., 2012 (Chapman & Hall / CRC Press)

    An overview of Bayesian statistical methods for the analysis of health economic data, covering economic evaluation concepts, statistical cost-effectiveness analysis, Bayesian computation and MCMC, and applied health economic evaluation.

Frequently Asked Questions (6)

  • What is a confidence interval?

    A range of values, calculated from sample data, expected to contain the true population parameter with a specified level of confidence.

    Source: Neyman 1937

  • What does a confidence interval convey about an estimate?

    A confidence interval is a range, computed from sample data, that is expected to contain the true population value with a stated level of confidence, such as ninety-five per cent. It conveys the precision of an estimate: a narrow interval means the data pin the value down tightly, while a wide one signals considerable uncertainty. By showing the span of values compatible with the data, it says far more than a single point estimate about how firmly a result is known. Expressing the uncertainty around an estimate is its purpose. Kirkwood and Sterne (2003) describe this.

    Source: Kirkwood & Sterne 2003

  • How is a confidence interval interpreted?

    A confidence interval is interpreted in terms of the procedure: a ninety-five per cent confidence interval means that if the study were repeated many times, about ninety-five per cent of the intervals so constructed would contain the true parameter. It is not correct, in the frequentist framework, to say there is a ninety-five per cent probability that the particular interval contains the parameter, since the parameter is fixed. So a confidence interval is interpreted as arising from a procedure that captures the true value a specified proportion of the time, conveying the precision of the estimate, with a wider interval indicating greater uncertainty and a narrower one greater precision.

    Source: Neyman 1937

  • How is a confidence interval calculated?

    A confidence interval is calculated from the point estimate, its standard error, and a multiplier from the relevant distribution corresponding to the confidence level, typically as the estimate plus and minus the multiplier times the standard error. For a ninety-five per cent interval based on a normal approximation, the multiplier is about 1.96. So a confidence interval is calculated by combining the estimate with a margin based on its standard error and the confidence level, which widens with greater variability or smaller samples, and the exact method depends on the parameter and the distribution, with approximate normal-based intervals common in large samples.

    Source: Neyman 1937

  • What affects the width of a confidence interval?

    The width of a confidence interval is affected by the sample size, the variability in the data, and the confidence level: larger samples and lower variability give narrower intervals, reflecting greater precision, while a higher confidence level, such as ninety-nine rather than ninety-five per cent, gives a wider interval. So the width of a confidence interval reflects the precision of the estimate, narrowing with more data and less variability and widening with a higher confidence level, which means a narrow interval indicates a precise estimate and a wide one considerable uncertainty, and the interplay of these factors is considered when designing studies to achieve adequate precision.

    Source: Neyman 1937

  • Why are confidence intervals useful?

    Confidence intervals are useful because they convey the precision of an estimate and a range of plausible values for the parameter, giving more information than a point estimate or a p-value alone, and helping to judge both statistical and practical significance. A wide interval warns of imprecision, and whether the interval includes a value of no effect is informative. So confidence intervals are useful for interpreting results, since they show how precisely a quantity is estimated and which values are compatible with the data, which supports better judgement than significance testing alone about the size and certainty of an effect.

    Source: Neyman 1937

Trust Record

Verified by Dr Darrin Baines

British health economist

Professional identity: darrinbaines.org

Verification date: 12 Dec 2025

Content version: 1.0.0

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Term code
HE-ES-SA-033

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