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儿童患乳病的查:多种遗传和血清学检测方法的成本效益

Jani Mäkinen¹, Paula Heikkilä², Juha Pajula³

¹Celiac Disease Research Center, Tampere University, Tampere, Finland; Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

|December 17, 2025

概括

儿童乳病 (CD) 查的最具成本效益的策略是在11岁时进行单一的非向血清学测试. 这种方法平衡了效率和成本,尽管区域因素可能会影响最佳实施.

科学领域:

儿科胃肠病学儿科胃肠病学
公共卫生公共卫生
卫生经济学卫生经济学

背景情况:

性疾病 (CD) 的诊断严重不足,导致患儿的诊断延迟了很长时间.
基于人口的查是提议提高早期检测,但成本效益仍然是一个关键的考虑因素.

研究的目的:

确定最具成本效益的儿童腹腔疾病查策略.
评估各种查情景,包括年龄,频率和遗传检测的整合.

主要方法:

使用瑞典数据的马尔科夫模型将272种查策略与没有查进行了比较.
评估一次性与重复的血清学测试 (3-18岁) 和初步遗传测试.
敏感性分析评估了影响最佳战略的因素和支付意愿值 (20,000欧元/QALY).

主要成果:

在默认情景中,在11岁时进行一次性,无针对性的查是最具成本效益的策略.
在4岁和11岁时重复查也有效,特别是如果CD患病率超过5%或查成本减半.
诊断延迟被确定为最佳查年龄的主要驱动因素.

结论:

在11岁时进行一次性,无针对性的血清学查是儿童腹腔疾病推的经济有效策略.
最佳的查方法可能因区域流行和经济因素而异.
对高风险人群或具有更高支付意愿值的人群来说,重复查可能是有益的.

关键词:

成本效益分析成本效益分析卫生经济学卫生经济学儿科查儿科查儿科查预防性医疗保健是预防性的医疗保健.

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