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在癌症分子测试中,价值是如何定义的? 一个范围广泛的审查

Alice Minhinnick¹, Francisco Santos-Gonzalez², Michelle Wilson³

¹University of Auckland, Auckland, New Zealand. alice.minhinnick@auckland.ac.nz.

Applied health economics and health policy

|July 9, 2024

概括

关于癌症分子测试的研究很少考虑超出临床结果的更广泛的价值概念. 传统的经济分析占主导地位,忽视了心理影响和患者偏好,阻碍了全面的社会价值评估.

科学领域:

卫生经济学卫生经济学
在瘤学瘤学.
分子诊断学分子诊断

背景情况:

基于价值的医疗保健强调了超越临床结果的更广泛的价值定义.
癌症分子检测越来越多地被利用,需要清楚地了解它的价值.
现有的文献可能不能完全捕捉分子测试的多方面的价值.

研究的目的:

确定如何在癌症分子测试研究中定义"价值".
评估本文献中扩大医疗保健价值观念的应用.

主要方法:

以乔安娜·布里格斯研究所 (JBI) 方法论为指导的范围审查.
在2023年8月的Medline,Embase,EconLit和Cochrane图书馆进行了搜索.
包括报告与癌症分子测试结果相对的成本,新成本或新结果的文章;使用定性内容分析合成结果.

主要成果:

包括91篇文章,主要是从医疗保健系统的角度看传统的经济分析 (75/91) (38/91).
临床结果,特别是质量调整后寿命年 (QALYs) (45/91),主导了价值评估 (61/91).
其他价值定义是多样化的,不一致的,并且在很大程度上与不断变化的指导意见不一致.

结论:

在癌症分子测试文献中,更广泛的价值概念的代表性不足.
传统的方法主要关注临床成本和结果,忽视非临床价值因素.
新出现的证据强调了心理后果;内在测试属性和患者偏好是实现社会价值的关键.

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