慢性阻塞性肺病查的成本效益:系统性审查和元分析
Chunyan Song1, Yuwei Xie2, Zhiqiang Feng2
1School of Public Health, Shandong Second Medical University, No. 7166 Baotong West Street, Weicheng District, Weifang, Shandong, 261053, P. R. China.
BMC public health
|November 4, 2025
概括
这项元分析发现,在初级保健中对慢性阻塞性肺病 (COPD) 的查是具有成本效益的. 螺旋计查为COPD检测提供了最佳的经济价值,特别是在高风险人群中.
科学领域:
- 肺部医学 肺部医学
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 慢性阻塞性肺病 (COPD) 构成了全球严重的健康负担.
- 通过查进行早期检测可能会改善患者的治疗结果并降低医疗保健成本.
- 各种COPD查策略的成本效益需要全面评估.
研究的目的:
- 综合关于COPD查成本效益的证据.
- 对不同选方法的增量成本效益比率 (ICER) 进行元分析.
- 量化COPD查策略的经济价值.
主要方法:
- 在主要数据库 (MEDLINE,EMBASE,Web of Science,Cochrane Library) 进行系统的文献搜索,直到2024年12月.
- 包括12项研究,包括1,082,021名参与者.
- 使用DerSimonian和Laird方法对ICER进行随机效应的元分析.
主要成果:
- 基于问卷进行查的ICER聚合:899.5美元 (95%CI [-1,903.9, 3,702.9]).
- 基于螺旋计的查的ICER:521.3美元 (95%CI [116.0,926.7]).
- 组合螺旋测量和问卷查的ICER聚合:$ 15,305.8 (95%CI [5,364.2, 25,247.4]). 这是一个很好的选择.
结论:
- 在初级保健机构进行COPD查是一种具有成本效益的干预措施.
- 基于螺旋计的查显示出有利的经济价值.
- 政策制定者应该考虑针对高风险群体 (吸烟者,老年人) 进行有针对性的查,并根据当地经济环境调整工具.
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