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在糖尿病模拟模型中使用QALY作为评估全球预测准确性的结果
Helen A Dakin1, Ni Gao1,2, José Leal1
1Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, UK.
概括
第二季度的指标准确地比较了糖尿病模拟模型,UKPDS-OM2显示了比UKPDS-OM1.1更好的质量调整寿命年 (QALY) 预测. 这有助于为医疗技术评估选择精确的模型.
科学领域:
- 卫生经济学 卫生经济学
- 生物统计学 生物统计学
- 医疗模拟 医疗模拟
背景情况:
- 糖尿病模拟模型通常通过预测单个临床事件来验证.
- 经质量调整的寿命年 (QALYs) 将死亡率和临床事件纳入决策.
- 现有的指标可能无法完全捕捉经济评估的整体模型性能.
研究的目的:
- 为了证明QALY作为比较模拟模型性能的结果指标.
- 确定用于医疗技术评估和经济评估的最准确的模拟模型.
- 为了探索Q2的实用性,比率降低错误,作为模型性能指标.
主要方法:
- 模拟了14729名EXSCEL试验参与者,使用英国前性糖尿病研究结果模型版本1和2 (UKPDS-OM1和UKPDS-OM2).
- 在试验期间使用观察到的事件和生存数据估计的QALY.
- 将UKPDS-OM1和UKPDS-OM2的QALY预测与观察到的QALY和对其他指标 (MSE,MAE,偏差,R2) 的评估Q2进行了比较.
主要成果:
- UKPDS-OM2比UKPDS-OM1 (Q2:0.822与0.786;MSE:0.210与0.253) 显示出更准确的QALY预测.
- UKPDS-OM2显示死亡率,心肌梗塞和中风预测的准确性有所提高.
- 第二季度对于比较全球预测准确度和识别有偏见的预测因素,与R2.2不同,证明是有用的.
结论:
- Q2是比较糖尿病模拟模型总体预测准确性的一个有价值的指标.
- Q2指标可以帮助选择最准确的模拟模型用于经济评估和医疗技术评估.
- 使用Q2用于QALYs的拟议方法可扩展到其他疾病领域,用于模型评估和重新校准.
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