通过决策分析模型预测的预期寿命,评估前列腺癌,肺癌,乳腺癌和结肠直肠癌的查:专注于竞争死亡风险的系统性审查
Christin Henning1, Gaby Sroczynski1, Lára Hallsson1
1Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria.
概括
癌症查模型经常预测预期寿命的增长,但对竞争死亡风险的计算显示出更小的好处. 先进的建模对于精确的癌症查评估至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 关于癌症查的死亡率降低是否转化为所有原因死亡率的降低和预期寿命的增加,存在争论.
- 决策分析模型经常预测癌症查可以大幅增加预期寿命.
- 准确的模拟竞争死亡风险对于评估查有效性至关重要.
研究的目的:
- 在决策分析查模型中,系统地审查竞争性死亡风险的方法特征.
- 评估这些特征如何影响癌症特异性死亡率降低转化为预期寿命增长.
- 覆盖前列腺,肺,乳腺和结直肠癌查模型.
主要方法:
- 对四种主要癌症类型的临床和经济决策分析模型进行系统的文献搜索.
- 42个选定的模型的叙事综合.
- 提取基本信息和特定的方法特征,重点关注竞争死亡风险.
主要成果:
- 所有的42个模型都预测了查的预期寿命增长,癌症类型和模型之间存在显著的差异.
- 纳入竞争性死亡风险或调整伴随疾病的模型预测查的终身收益较小.
- 预测的预期寿命增长,自然历史假设和方法特征存在显著差异.
结论:
- 与竞争死亡风险相关的关键建模特征必须在癌症查的决策分析模型中考虑.
- 考虑竞争性死亡风险导致对查预期寿命增长的更为保守的估计.
- 未来的研究应该采用先进的建模技术,纳入竞争的死亡风险,以改善癌症查的益处-危害评估.
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