局部麻醉的成本效益 跨关节与跨直肠活检:来自TRANSLATE研究的结果
Matthew Little1, Jane Wolstenholme1, Filipa Landeiro1
1Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
European urology focus
|December 12, 2025
概括
局部麻醉性跨关节 (LATP) 前列腺活检比跨直肠超声波 (TRUS) 活检更昂贵,在4个月后的质量调整寿命年 (QALYs) 中没有显著差异. 需要进一步分析来评估长期的成本效益.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 卫生经济学 卫生经济学
- 医疗成像医学成像
背景情况:
- 与跨直肠超声波 (TRUS) 活检相比,局部麻醉超声波引导的跨关节 (LATP) 前列腺活检提供了更好的癌症检测和减少感染风险.
- 与TRUS活检相比,LATP的成本效益仍然不确定.
研究的目的:
- 为了在4个月的随访期内比较LATP活检与TRUS活检的成本效益.
- 从国家卫生服务的角度评估医疗保健成本和质量调整寿命 (QALYs).
主要方法:
- 一项随机临床试验 (TRANSLATE) 涉及1126名先前没有做过活检的男性,并进行了预活检MRI.
- 在试验内进行经济分析,评估资源使用,成本和QALYs在活检后4个月内.
- 缺少数据的多重归算和用于不确定性分析的非参数引导.
主要成果:
- 与TRUS活检 (917英) 相比,LATP活检在4个月的平均成本 (1062英) 较高 (调整后的平均差异为149英,p=0.001).
- 在4个月后LATP (0.282) 和TRUS (0.284) 臂之间没有观察到平均QALYs的显著差异 (p=0.098).
结论:
- LATP活检与更高的直接成本有关,但与4个月后的TRUS活检相比,QALYs没有显著差异.
- 4个月的随访不足以捕捉LATP对前列腺癌结果的诊断提升的潜在长期益处.
- 为了全面了解LATP活检的成本效益,需要在4个月以后进行进一步的经济评估.
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