对左截断和右截断的生存数据与治疗延迟的成本效益分析的统计方法
Polyna Khudyakov1, Li Xu1, Ce Yang1
1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
Journal of the Royal Statistical Society. Series C, Applied statistics
|November 17, 2025
概括
我们开发了新的成本效益分析方法,使用考克斯的比例危险模型,考虑治疗延迟. 这种方法改善了公共卫生干预措施的估计,正如艾滋病患者的成本效益评估所显示的那样.
科学领域:
- 卫生经济学 卫生经济学
- 生物统计学 生物统计学
- 流行病学 流行病学
背景情况:
- 成本效益分析对于医疗保健资源分配至关重要.
- 增量成本效益比率 (ICER) 和增量净收益 (INB) 是关键指标.
- 现有的方法可能无法完全解释公共卫生中的治疗开始延迟.
研究的目的:
- 开发用于估计ICER和INB的新统计方法.
- 将风险因素调整和治疗延迟时间纳入成本效益模型.
- 在现实世界公共卫生环境中评估治疗策略的成本效益.
主要方法:
- 使用半参数分层的考克斯比例危险模型.
- 开发了ICER和INB的估计和推断程序.
- 纳入的方法来解释治疗启动的延迟.
- 通过广泛的模拟研究验证了拟议的方法.
主要成果:
- 拟议的估计器在各种延迟场景中展示了出色的有限样本特性.
- 这些方法允许对相关风险因素进行可靠的调整.
- 模拟结果证实了新方法在不同条件下的可靠性.
结论:
- 开发的方法为公共卫生中的成本效益分析提供了统计学上健全的框架.
- 为了准确的经济评估,对治疗延迟的核算至关重要.
- 该方法适用于评估干预措施,例如艾滋病患者的治疗转换.
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