预后和预测伴随诊断的经济评估中的方法方法方法:系统的范围审查
Tuukka Hakkarainen1, Haavisto Ira2, Leskelä Riikka-Leena2
1Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.
Expert review of pharmacoeconomics & outcomes research
|June 16, 2025
概括
本次审查强调了对预后和预测伴随诊断 (pCDx) 的经济评估的变化. 标准化方法和改进不确定性分析对于可靠的pCDx评估至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 医学诊断 医学诊断 医学诊断
- 卫生技术评估 卫生技术评估
背景情况:
- 基于模型的经济评估 (EE) 对于评估预后和预测伴随诊断 (pCDx) 的价值至关重要.
- 目前对pCDx EEs的方法方法方法表现出可变性和存在挑战.
- 需要进行系统审查来识别和分析这些方法及其局限性.
研究的目的:
- 识别和分析pCDx的基于模型的EEs当前的方法方法.
- 突出pCDx.经济评估中的方法差距和挑战.
- 为提高pCDx评估的可靠性提供建议.
主要方法:
- 在PubMed和Scopus进行系统搜索 (2009年1月至2023年3月).
- 包括基于模型的EEs,方法论文和pCDx的评论.
- 用修改后的CHEERS检查清单在六个领域提取的数据的叙述综合.
主要成果:
- 包括88项研究;60项是基于模型的EEs,主要使用马尔科夫或混合模型.
- 质量调整寿命年 (QALYs) 是主要结果;很少有研究使用RCT数据或建模诊断准确性.
- 方法限制包括不一致的途径建模,对预测概率的考虑不足,以及不充分的不确定性分析.
结论:
- 在pCDx的经济评估中存在显著的变化和方法差距.
- 标准化评估方法,整合现实世界的证据,解决诊断准确性和不确定性是必不可少的.
- 乳腺癌研究的过度代表是一个局限性.
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