结构化专家诱导以告知晚期细胞癌的长期存活推断
Dawn Lee1, Zain Ahmad2, James M G Larkin3
1PenTAG, University of Exeter, University of Exeter Medical School, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK. d.lee7@exeter.ac.uk.
Applied health economics and health policy
|August 27, 2025
概括
对晚期细胞癌的治疗提供了有价值的长期生存估计,为成本效益分析提供了信息. 这种有效的方法可以指导快速发展的癌症治疗途径的决策.
科学领域:
- 癌症学
- 健康经济学
- 临床研究方法
背景情况:
- 由于缺乏长期数据,需要评估推断的临床可信性.
- 结构化专家提取 (SEE) 为此目的收集专家的判断和不确定性.
- 晚期细胞癌 (RCC) 的治疗途径正在迅速发展.
研究的目的:
- 获得高级RCC治疗的长期结果的专家估计.
- 为国家卫生和护理卓越研究所 (NICE) 的成本效益分析提供信息.
- 在一个复杂的,时间敏感的环境中评估SEE的可行性.
主要方法:
- 使用STEER存储库和MRC协议进行研究设计.
- 招募了来自英国不同地区的9名瘤学家.
- 通过在线调查 (轮盘方法) 收集无病变生存率 (PFS) 和整体生存率的数据,并使用线性意见聚合进行汇总.
主要成果:
- 专家预测,从5年开始,免疫瘤学/ 铁激酶抑制剂 (TKI) 组合和TKI单一治疗对一线中级/ 低风险患者的PFS类似.
- 在第一线治疗中,预计尼沃卢马布+伊皮利穆马布产生的PFS最高.
- 专家估计与实际证据相比是乐观的,但与试验数据相比却是悲观的.
结论:
- 在不断变化的治疗环境中,SEE是一种实用且高效的方法,可以为长期生存推断提供信息.
- 证明在8周的时间内对复杂的决策问题进行专家调研的可行性.
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