遺伝子診断のためのゲノムシーケンシングとエクソームシーケンシングを比較するランダム化試験によるマイクロコストとコスト結果分析
Wendy J Ungar1, Vercancy Wu1, Christian R Marshall2
1Program in Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, ON, Canada.
まとめ
ゲノムシーケンシング (GS) は,珍しい疾患の診断にエクソームシーケンシング (ES) よりも高価で,同様の診断結果が得られます. GSによって唯一検出可能な変種を評価するには,さらなる研究が必要です.
科学分野:
- ゲノミクス
- 医学経済学
- 希少 疾患 の 診断
背景:
- 希少疾患の診断は 経済的にも大きな課題です
- 医療従事者にとって 異なる遺伝子配列解析の費用対効果を理解することは 極めて重要です
研究 の 目的:
- マイクロコスト エクソームシーケンシング (ES) と ゲノムシーケンシング (GS) で 希少疾患の診断を行う.
- 組織的な支払者の観点から,GSとESの追加診断コストを推定する.
主な方法:
- ランダムに割り当てられたトリオ (プロンブと親) はESかGSである.
- 実験室のワークフローとシーケンスのマイクロカスタリング
- 効果の尺度として診断収率を用いて,トリオ毎の総コストとカテゴリーコストを推定する.
主要な成果:
- ESの平均総コストは2888.79 CAD,GSの平均総コストは4364.02 CADでした.
- 反応剤のコストはESの34%,GSの61%を占めた.
- GSのインクリメンタルコストは1475.23 CADで,ESの35.9%と比較して診断収率は32.7%でした.
結論:
- ゲノムシーケンシング (GS) はエクソームシーケンシング (ES) よりもコストが高く,この研究でも同様の診断結果が得られました.
- 試験時の技術的な限界がGSの診断結果に影響を及ぼした可能性があります.
- 発見は,診断戦略を比較するために重要なコストデータを提供し,GSによって唯一識別された変種を探求する必要性を強調します.
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