使用基因组风险信息的黑色素瘤预防计划的长期成本效益与澳大利亚的标准预防建议相比
Chi Kin Law1, Anne E Cust2, Amelia K Smit2
1NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia.
概括
个性化基因组风险提供是预防黑色素瘤,减少晒伤和潜在地预防未来皮肤癌的成本有效策略. 这种方法在针对具有高传统风险因素的个体时尤其有效.
科学领域:
- 基因组医学是一种基因组医学.
- 公共卫生 公共卫生
- 皮肤病学 皮肤病学
背景情况:
- 包括个性化基因组风险和遗传咨询在内的黑色素瘤预防计划在修改风险行为方面表现有前途.
- 研究表明,这些计划可以减少没有先前黑色素瘤病史的成年人中晒伤的发生率.
- 评估长期经济影响对于实施医疗保健系统至关重要.
研究的目的:
- 评估黑色素瘤预防计划的长期成本效益,利用个性化基因组风险提供.
- 该分析采用澳大利亚医疗保健系统的视角.
- 与标准预防建议进行比较.
主要方法:
- 使用决策分析的马尔科夫模型来模拟终身成本效益.
- 来自随机试验的数据为模型提供了信息,成本以2018/19年澳大利亚美元 (AUD) 表示.
- 干预对减轻晒伤的影响按性别和传统风险分层,并对强度进行敏感性分析.
主要成果:
- 干预的成本为每位参与者189澳元.
- 针对传统的高风险人群,每年获得的经质量调整后的生命年,增量性成本效益比 (ICER) 为35,254澳元.
- 将干预扩展到传统的低风险群体,导致ICER达到43,746澳元,成本效益的概率为45%.
结论:
- 基因组风险规定,当针对高传统黑色素瘤风险个体时,代表了一个可能具有成本效益的预防策略.
- 这种方法预计将减少日晒伤,并防止未来发生黑色素瘤和角质细胞癌.
- 这些发现支持将个性化基因组风险评估纳入预防皮肤癌的公共卫生战略.
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