在全方位新生儿听力查中优化决策:信息视角的价值
Rajan Sharma1, Yuanyuan Gu1, Kompal Sinha2
1Macquarie University Centre for the Health Economy (MUCHE), Macquarie University, NSW, Australia; Macquarie Business School (MQBS), Macquarie University, NSW, Australia; Australian Institute of Health Innovation (AIHI), Macquarie University, NSW, Australia.
澳大利亚的全民新生儿听力查 (UNHS) 计划具有成本效益,但建议对实用值进行进一步研究. 从300-500多名儿童收集数据可以显著减少不确定性,并为未来的决策提供信息.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 决策分析 决策分析
背景情况:
- 关于澳大利亚全民新生儿听力查计划 (UNHS) 的成本效益存在不确定性.
- 信息价值 (VOI) 分析是评估是否需要进一步研究的框架.
- 最近的进步使得VOI分析在决策中变得更加可行.
研究的目的:
- 为澳大利亚的UNHS计划量化额外研究的价值.
- 通过估计证据的价值来指导未来的研究重点.
- 确定所需的样本大小,以最大限度地提高决策信息的价值.
主要方法:
- 开发了一个决策分析模型,包括一个决策树和一个具有26年时间视界的马尔科夫模型.
- 使用澳大利亚纵向研究和已发表的数据评估了UNHS与不进行查的成本效益.
- 估计了完美信息的预期值 (EVPI),部分信息的预期值 (EVPI) 和样本信息的预期值 (EVSI).
主要成果:
- 增量成本效益比 (ICER) 为每次质量调整寿命年 (QALY) 39400美元,在40900美元/QALY门时,成本效益的概率为50%.
- 在10年内,250万新生儿的EVPI为1.3030亿美元.
- 实用值,特别是它们与诊断年龄的关联,是不确定性的主要来源,EVSI建议300-500个额外的实用数据点,价值1.06亿美元.
结论:
- 尽管存在一些不确定性,但澳大利亚的UNHS计划在值以下表现出了成本效益.
- 收集额外的实用数据对于减少决策不确定性至关重要.
- 这些发现对澳大利亚和全球的UNHS计划有影响.
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