来自随机对照试验的微成本和成本后果分析,将基因组测序与外体测序进行基因诊断
Wendy J Ungar1, Vercancy Wu1, Christian R Marshall2
1Program in Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, ON, Canada.
概括
基因组测序 (GS) 比外基因组测序 (ES) 更昂贵,用于诊断罕见疾病,具有相似的诊断产量. 需要进一步的研究来评估GS唯一可检测的变异.
科学领域:
- 基因组学
- 医学经济学
- 罕见疾病的诊断
背景情况:
- 诊断罕见疾病带来了巨大的经济挑战.
- 了解不同基因测序方法的成本效益对于医疗保健提供者来说至关重要.
研究的目的:
- 用于微成本的外体测序 (ES) 和基因组测序 (GS) 来诊断罕见疾病.
- 从机构付款人的角度来看,估计每次额外诊断的GS与ES的附加成本.
主要方法:
- 随机分配三组 (探测器加上父母) 给ES或GS.
- 实验室工作流程和测序过程的微成本.
- 每个三组的总和类别成本的概率估计,诊断产量作为有效性的衡量标准.
主要成果:
- 每三人的平均总成本为ES的2888.79加元,GS的4364.02加元.
- 试剂成本占ES成本的34%和GS成本的61%.
- GS的增量成本为1475.23加元,诊断收益率为32.7%,而ES的收益率为35.9%.
结论:
- 基因组测序 (GS) 比外基因组测序 (ES) 更昂贵,在本研究中提供了类似的诊断产量.
- 研究时的技术限制可能影响了GS的诊断产量.
- 这些发现为比较诊断策略提供了必要的成本数据,并强调需要探索GS唯一识别的变异.
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