高风险人群中肺癌低剂量计算机断层扫描查的成本效益:马尔科夫模型
Chau-Chyun Sheu1,2, Chun-Chun Wang3,4, Jui-Sheng Hsu5,6
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan, Republic of China.
World journal of oncology
|July 12, 2024
概括
低剂量计算机断层扫描 (LDCT) 比胸部X射线 (CXR) 在台湾的肺癌查中更具成本效益. 预计对高风险人群的LDCT查将节省超过1700万美元,并减少死亡率.
科学领域:
- 卫生经济学 卫生经济学
- 医疗成像医学成像
- 在瘤学瘤学.
背景情况:
- 关于低剂量计算机断层扫描 (LDCT) 用于肺癌查的成本效益的研究有限.
- 关于台湾的LDCT成本效益的证据很少.
- 这项研究通过比较LDCT和胸部X射线 (CXR) 对台湾肺癌查的成本效益来弥补这一差距.
研究的目的:
- 对台湾肺癌查的LDCT与CXR进行全面的成本效益分析.
- 为医疗保健决策者提供关于肺癌查策略的证据.
主要方法:
- 从医疗保健提供者的角度来看,使用马尔科夫决策模型模拟使用LDCT和CXR进行两年一次的查.
- 数据输入包括概率,质量调整后寿命年 (QALYs) 和与查,诊断和治疗相关的成本.
- 进行了1000次模拟和灵敏度分析,以确定增量成本效益比 (ICUR).
主要成果:
- 与CXR相比,LDCT的ICUR (-24,757.65/QALY) 显著较低,在台湾的人均GDPWTP值下100%的采用同意.
- 敏感性分析表明,召回率对ICUR有很大的影响.
- 对高风险人群的LDCT查可能会节省大约17,154,115美元的成本.
结论:
- LDCT是台湾肺癌查中比CXR更节省成本和有效的策略.
- LDCT可以检测到更多的早期肺癌,并降低死亡率.
- 未来的研究应该通过额外的变量来探索成本效益.
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