美国对基因组测试的支付方观点:一个系统的文献审查
Julie Wiedower1, Hadley Stevens Smith2, Christopher L Farrell3
1Clemson University, School of Nursing, Clemson, SC; Guardant Health, Redwood City, CA.
概括
了解医疗保健支付人对基因组测试的看法对于推进基因组医学至关重要. 本次审查强调了支付人对临床实用性,覆盖范围和成本的看法,并确定了更广泛采用的挑战和机会.
科学领域:
- 基因组医学是基因组医学.
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- 利益相关者对基因组测试价值的看法各不相同,影响基因组医学.
- 美国医疗保健支付人对基因组测试的看法尚未被系统审查.
研究的目的:
- 系统地审查美国医疗保健支付人的基因组测试观点.
- 确定影响支付人的基因组测试决策的关键领域.
主要方法:
- 对MEDLINE,PubMed和CINAHL数据库的系统文献审查.
- 包括从161个选的非重复记录中识别的20个记录.
- 应用框架方法来识别共同的领域.
主要成果:
- 主要领域:临床效用,覆盖决策框架,危害,成本,研究付款,需求,结果灵活性和个人效用.
- 关于临床效益的共识定义为改善健康结果.
- 在将基因组测试细微差别融入现有覆盖框架中存在挑战;付款人对更广泛的结果和成本影响的看法各不相同.
结论:
- 了解付款人的观点对于与其他利益相关者进行比较至关重要.
- 确定挑战和机会,以更好地展示基因组测试价值.
- 旨在协调基因组测试采用的概念和证据框架.
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