使用基于eGFR的累积统计数据进行慢性病查的成本效益
Reyhaneh Zafarnejad1, Qiushi Chen2, Paul M Griffin2
1Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
PloS one
|March 13, 2024
概括
使用CUSUMGFR进行慢性病 (CKD) 常规查是具有成本效益的. 从30岁开始的全民年度查提供了最佳价值,易于整合到临床实践中,用于早期检测和预防.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 卫生经济学 卫生经济学
- 预防医学 预防医学
背景情况:
- 慢性病 (CKD) 查缺乏确定的指导方针,阻碍了及时干预.
- 早期发现CKD对于减缓疾病进展和预防并发症至关重要.
研究的目的:
- 评估CKD查的成本效益,使用估计膜过率 (CUSUMGFR) 的新累积总统计数据.
- 将基于CUSUMGFR的各种查策略与现状进行比较.
主要方法:
- 开发了一个微模拟模型来模拟美国队列 (年龄≥30岁) 中的CKD进展,并发症和治疗坚持.
- 评估了使用CUSUMGFR.使用的普遍查 (每年/每两年,从30/60开始) 和目标查 (高血压,糖尿病).
- 评估残疾调整寿命年 (DALYs) 和直接医疗成本,计算增量成本效益比率 (ICERs).
主要成果:
- 所有基于CUSUMGFR的查政策都在5万美元至10万美元的支付意愿 (WTP) 范围内表现出成本效益.
- 从30岁开始的全民年检成为最具成本效益的非主导政策,WTP的价格为25,000美元.
- 结合SGLT2抑制剂节省了成本;CKD进展率,坚持和测试成本是关键灵敏度参数.
结论:
- 基于CUSUMGFR的CKD查政策对于早期检测末期病风险非常具有成本效益.
- CUSUMGFR的简单性,只需要基本的血液检测,使其更容易融入监测和预防的临床工作流程.
相关概念视频
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01:23Renal Clearance
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