长期发现病例和大规模查儿童病的成本效益
Jan Heijdra Suasnabar1, Caroline R Meijer2, Lucy Smit3
1Department of Biomedical Data Science, Leiden University Medical Centre, Leiden, the Netherlands.
Gastroenterology
|July 31, 2024
概括
通过对儿童进行临床检测,早期发现儿童的乳病 (CD) 是具有成本效益的. 与当前护理相比,大规模查和病例发现策略都改善了健康结果,大规模查可能是最佳的.
科学领域:
- 儿童自身免疫性疾病
- 公共卫生战略 公共卫生战略
- 卫生经济学 卫生经济学
背景情况:
- 乳病 (CD) 是一种常见的自身免疫性疾病,通常是晚期诊断出来的.
- 对CD抗体的临床检测可以促进初级保健中早期检测.
- 关于早期CD检测策略的成本效益的证据有限.
研究的目的:
- 估计与荷兰目前的临床检测方法相比,在儿童中发现活跃病例和对CD进行大规模查的长期成本效益.
主要方法:
- 一个决策树和马尔科夫模型模拟了一个3岁儿童队列.
- 该模型评估了长期成本 (社会视角) 和经质量调整的寿命年 (QALY).
- 数据来源于GLUTENSCREEN项目,荷兰乳病学会和已发表的文献.
主要成果:
- 大规模查产生了7.46个更多的QALY,额外成本为28,635欧元 (ICER:3841欧元/QALY).
- 案例调查结果为4.33个更多的QALY,额外费用为15,585欧元 (ICER:3603欧元/QALY).
- 这两种策略都非常具有成本效益,愿意支付20,000欧元/QALY;大规模查可能是最佳的.
结论:
- 在儿童中通过临床检测及早发现CD可以改善健康结果,并且在长期内具有成本效益.
- 如果可行和可接受,建议在荷兰医疗保健中实施这些策略.
- 通过查或病例发现,通过早期诊断,比目前的护理提供了显著的好处.
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