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在人口范围内的CKD查中平衡效率和公平.
Marika M Cusick1, Rebecca L Tisdale2,3, Alyce S Adams1,4
1Department of Health Policy, School of Medicine, Stanford University, Stanford, California.
JAMA network open
|April 14, 2025
概括
从55-75岁开始对全人口进行慢性病 (CKD) 查是具有成本效益的,并减少了健康差异. 早期查最有利于非西班牙裔黑人成年人,改善了所有种族和民族群体的结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- -葡萄糖共运输体2 (SGLT2) 抑制剂为CKD提供了新的治疗途径.
- 建立了全人口CKD查价值,但种族/种族影响尚不清楚.
研究的目的:
- 评估CKD查在不同种族和民族群体的健康结果,成本和成本效益.
- 评估SGLT2抑制剂与查相关的影响.
主要方法:
- 使用决策分析马尔科夫模型进行成本效益分析.
- 在美国西班牙裔,非西班牙裔黑人,非西班牙裔白人和其他种族/民族成年人群体中模拟CKD进展.
- 结合了来自临床试验的SGLT2抑制剂有效性数据和真实世界的成本/死亡数据.
主要成果:
- 在所有组中,每5年 (年龄55-75岁) 用SGLT2抑制剂进行一次查,可以减少功能衰竭和增加寿命.
- 非西班牙裔黑人成年人显示出最大的改善;查对这个群体来说是最具成本效益的.
- 从35岁开始的查仅对非西班牙裔黑人成年人具有成本效益.
结论:
- 全民性CKD查 (55-75岁) 改善健康,具有成本效益,并减少差异.
- 早期查 (35岁) 提供了额外的好处,特别是对于非西班牙裔黑人成年人.
- 查策略应考虑年龄和种族/种族,以获得最佳的CKD管理.
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