对卵巢癌7种诊断策略的成本后果分析:基于模型的经济评估
Samuel J Perry1, Donal Griffin1, Eleanor V Williams1
1Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK.
BJOG : an international journal of obstetrics and gynaecology
|November 6, 2025
概括
没有单一的卵巢癌诊断策略是所有患者的最佳选择. 在10%的门下,IOTA ADNEX的两步策略提供了早期诊断,癌症死亡率降低和成本效益的最佳平衡.
科学领域:
- 妇科瘤学 妇科瘤学
- 卫生经济学 卫生经济学
- 诊断准确性研究 诊断准确性研究
背景情况:
- 患有症状的女性卵巢癌的诊断在二级护理中提出了挑战.
- 评估各种诊断策略的成本效益对于优化患者的治疗结果和资源配置至关重要.
研究的目的:
- 为了比较患有症状的绝经前后妇女卵巢癌的七种诊断策略的成本和后果.
- 确定最具成本效益的策略,平衡诊断产量,癌症死亡率和费用.
主要方法:
- 基于模型的成本后果分析 (CCA) 与前性诊断准确性研究一起进行.
- 通过使用决策树,在12个月内模拟了患者的路径.
- 来自ROCkeTS研究和文献的数据为诊断准确性和成本估计提供了信息.
主要成果:
- 没有任何一种策略在所有结果中都是最佳的; 恶性瘤风险指数 (RMI) 200是最便宜但最不有效的,而ADNEX 3%是最有效但最昂贵的.
- 对于绝经前妇女来说,IOTA ADNEX 10%与ORADS,ROMA和CA125.5相比显示出更高的成本效益.
- 两步IOTA ADNEX 10%策略表明,在两种队列的敏感性分析中,癌症死亡率,诊断产量和成本之间的最佳整体权衡.
结论:
- 对于卵巢癌来说,没有一种单一的诊断策略在12个月内普遍优越.
- 早期诊断需要平衡癌症死亡率,诊断产量和经济因素.
- 由于其平衡的性能,IOTA ADNEX 10% 门的两步策略被推用于临床实践.
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