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抗生素或桃体切除术治疗成人复发性桃体炎:分析两个邪恶中较小的邪恶
Tommy Jacob1, Moshe Leshno2, Narin Nard Carmel-Neidermann1
1The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
The Laryngoscope
|November 8, 2023
概括
桃体切除术为患有复发性桃体炎 (RT) 的成年人提供了质量调整的生命年 (QALY) 收益,在2年内每年有3次以上的发作. 经过这一门,手术干预变得具有成本效益,尽管最初的成本较高.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 卫生经济学 卫生经济学
- 决策分析 决策分析
背景情况:
- 复发性桃体炎 (RT) 显著影响生活质量和医疗保健成本.
- 手术干预 (桃体切除术) 和持续抗生素治疗的最佳时间仍在争论中.
研究的目的:
- 确定在患有复发性桃体炎的成年患者手术干预的最佳时间.
- 为了评估桃体切除术的成本效益,与重复抗生素治疗相比.
主要方法:
- 一个马尔科夫模型是使用基于文献的数据用于复发性桃体炎开发的.
- 敏感性分析 (一向和蒙特卡洛概率) 评估了对结果的变量影响.
- 模型结果包括质量调整的寿命年 (QALYs) 和增量成本效益比率 (ICERs).
主要成果:
- 桃体切除术在每年有两次或更多次桃体炎的患者中产生积极的QALY增长,在2年后变得有意义.
- 桃体切除术比抗生素的增量成本为3,831美元.
- 桃体切除术的ICER为每QALY获得的44,741美元,超出了NICE指南,但在其他可接受范围内.
结论:
- 患有复发性桃体炎的成年人经历了至少2年的每年3次以上的发作,在QALY方面受益于桃体切除术.
- 桃体炎发作的频率和持续时间随着QALY增长而增加.
- 虽然不符合NICE指南,但桃体切除术的成本效益在更广泛的可接受经济基准范围内.
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