优化医疗与医疗研究资源的有效利用:以瑞典腹主动脉瘤筛查为例

Informing the efficient use of health care and health care research resources ‐ the case of screening for abdominal aortic aneurysm in Sweden

Health Economics · 2006
被引 12
人大 A-

中文导读

运用贝叶斯决策理论和价值信息分析框架,评估瑞典腹主动脉瘤筛查的成本效果,发现筛查很可能具有成本效果,且进一步研究价值有限,与瑞典卫生技术评估委员会的建议形成对比。

Abstract

BACKGROUND: An analytical framework using Bayesian decision theory and value-of-information analysis has recently been advocated for the economic evaluation of health technologies. The purpose of this study was to apply this framework to screening for abdominal aortic aneurysm (AAA) in Sweden and to compare the conclusions from this study with the conclusions presented in an assessment performed by the Swedish Council of Technology Assessment (SBU). METHODS: A probabilistic decision-analytical model was developed to establish the cost-effectiveness of a screening programme for AAA relative to current clinical practice and to calculate the value-of-information. RESULTS: The cost per quality-adjusted life-year for screening was 9700 euro. The expected value of perfect information for the assessment of overall cost-effectiveness was low, suggesting little benefit in conducting further research. Expected value of perfect partial information indicated that rupture probabilities were associated with the highest uncertainty. By contrast, the SBU report concluded there was limited evidence of cost-effectiveness and proposed further research. CONCLUSION: The investigated screening programme for AAA is likely to be cost-effective and conducting another clinical trial is unlikely to add much valuable information to this decision problem. These recommendations contrast with the vaguer recommendations from SBU that more evidence is required of costs-effectiveness.

腹主动脉瘤筛查成本效果分析贝叶斯决策理论信息价值分析