双室节拍的成本效益与腹腔节拍相比,对于鼻节功能障碍的腹腔节拍具有成本效益
Stéphane Rinfret1, David J Cohen, Gervasio A Lamas
1Department of Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), University of Montreal, Montreal, Canada.
Circulation
|January 5, 2005
概括
双室节奏改善了生病鼻综合征患者的生活质量. 这种先进的节奏方法提供了长期的成本效益,使其成为改善患者结果的可接受选择.
科学领域:
- 心脏病学 心脏病学
- 卫生经济学 卫生经济学
- 医疗技术评估 医疗技术评估
背景情况:
- 患有恶性鼻综合征 (SSS) 的患者通常需要心脏起器.
- 双腔鼓动 (DCP) 与单腔心室鼓动 (VVI) 相比,提供了更多的好处,包括改善生活质量.
- 与SSS的VVI相比,DCP的成本效益仍然是一个关键考虑因素.
研究的目的:
- 评估双室节拍与腹腔节拍在患有恶性鼻综合征的患者中的增量成本效益.
- 在患者一生中预测双室节奏的长期成本效益.
主要方法:
- 利用了2010年患者随机试验的4年数据.
- 采用马尔科夫模型,与试验数据校准,用于终身预测.
- 进行了1000次引导分析和多次灵敏度分析以确保稳定性.
主要成果:
- 双室节奏显示,在最初的4年中,每年质量调整后寿命 (QALY) 增加了53000美元的增量成本效益比 (ICER).
- 终身预测显示,质量调整后的预期寿命显著增加,每QALY获得的ICER约为6,800美元.
- 在启动和灵敏度分析中一致观察到成本效益,在共同的支付意愿值时,DCP在90%以上的模拟中具有成本效益.
结论:
- 双室节奏是患有恶性鼻综合征的患者的经济有效的策略,需要植入心脏起器.
- 该技术以普遍可接受的成本提高了质量调整后的预期寿命.
- DCP代表了一种有价值的治疗选择,可以改善SSS患者的长期结果.
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