用2周补丁监视器进行AF查的成本效益:mSToPS研究
Matthew R Reynolds1, Amy B Stein2, Xiaowu Sun2
1Division of Cardiology, Lahey Hospital and Medical Center, Burlington, MA (M.R.R.).
Circulation. Cardiovascular quality and outcomes
|October 31, 2023
概括
使用贴片监测器对老年美国人进行心房动 (AF) 查是具有成本效益的,显示出高经济价值和更好的结果. 建议进行进一步的随机试验以证实这些发现.
科学领域:
- 心脏病学 心脏病学
- 卫生经济学 卫生经济学
- 预防医学 预防医学
背景情况:
- mSToPS研究表明,用2周的贴片监测器查患有心房动 (AF) 和中风风险的老年美国人,增加了AF诊断和抗凝药处方.
- 与匹配的对照组相比,这种查方法在3年内改善了临床结果,但其成本效益尚未先前评估.
研究的目的:
- 在老年美国人中使用2周贴片监视器对AF查进行健康经济分析.
- 评估与此AF查策略相关的终身成本,生存率和质量调整寿命年 (QALYs).
主要方法:
- 一项美国的健康经济分析利用了来自mSToPS研究的患者级数据.
- 使用索赔数据,对临床结果,资源使用和成本进行了为期3年的跟踪.
- 使用回归建模和美国生命表来预测终身成本,生存率和QALY,并将倾向性得分与组调整相匹配.
主要成果:
- 监测组在3年内总成本略高 (每人增加1551美元),但急诊和住院次数较少.
- 终身预测显示,监测组的质量调整生存率略高 (0.09 QALY).
- 增量成本效益比为每QALY获得的36,100美元,其中64%的引导复制品低于50,000美元/QALY.
结论:
- 在老年美国人中使用2周贴片监测器进行AF查,表明其具有很高的经济价值.
- 研究结果表明,这种查方法是预防中风的成本有效策略.
- 通过随机试验进行进一步确认是有必要的,以验证这些经济发现.
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