重新思考结核病发病率量化:系统性审查和对结核病残疾权重的批判性评估在成本效益分析中
Ewan M Tomeny1, Thomas Hampton2,3,4, Phuong Bich Tran5
1Clinical Sciences Department, Liverpool School of Tropical Medicine, Liverpool, UK. ewan.tomeny@lstmed.ac.uk.
PharmacoEconomics
|August 7, 2024
概括
这项研究发现,结核病成本效益分析中使用残疾权重的方式存在不一致. 需要更严格的应用和报告,以更好地反映结核病的全部经验.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 包含残疾权重的残疾调整寿命年 (DALY) 指标对于卫生资源分配和结核病 (TB) 成本效益分析 (CEA) 至关重要.
- 准确的残疾权重对于制定或拒绝结核病干预的决策至关重要.
研究的目的:
- 审查结核病相关CEA中使用的残疾权重的值和一致性.
- 确定目前对结核病的残疾权重的应用方法上的差距.
主要方法:
- 系统审查塔夫斯CEA数据库,更新至2023年7月,使用Embase,Scopus和PubMed进行搜索.
- 包括评估结核病干预措施或使用结核病相关权重的研究,考虑各种结核病健康状况 (例如,有/没有艾滋病毒共感染,治疗,副作用).
- 由两位作者进行独立的数据选和提取.
主要成果:
- 分析了50个国家的105项研究 (2002-2023年),主要使用全球疾病负担 (GBD) 权重 (61%).
- 发现了不一致性:只有47%的GBD重量使用引用了明确的值和引用.
- 在表现结核病与艾滋病毒共感染,耐药性和心理影响方面存在方法上的差距;只有30%的研究对体重进行了敏感性分析.
结论:
- 对于结核病残疾权重的应用,敏感性测试和报告,需要提高严格性.
- 研究人员的目标是将结核病经验的各个方面纳入当前的GBD残疾权重中没有完全捕捉到的TB经验.
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