概括
将肝炎C病毒 (HCV) 查扩展到所有成年人或1945-1975年出生队伍中,更具成本效益,比单独基于风险的查识别更多的感染. 这种方法可以改善患者的治疗结果,并减少HCV的负担.
科学领域:
- 公共卫生 公共卫生
- 肝病学 肝病学是一种肝病学.
- 卫生技术评估 卫生技术评估
背景情况:
- 型肝炎病毒 (HCV) 感染可能导致严重的肝病,包括肝硬化,肝衰竭和肝细胞癌 (HCC).
- 通过查进行早期检测对于将感染者与护理和治疗联系起来至关重要,防止疾病的进展.
- 目前的查依赖于基于风险的方法,可能缺失无症状病例.
研究的目的:
- 评估一次性普遍HCV查对所有成年人和1945-1975年出生队伍的有效性和成本效益,与单独基于风险的查相比.
- 为了评估公共资金对预算的影响,安大略省扩大了HCV查计划.
- 了解患者对HCV查的偏好和价值观.
主要方法:
- 对临床证据和患者偏好进行系统的文献搜索.
- 使用ROBINS-I进行偏差风险评估和使用GRADE标准进行质量评估.
- 从公共付款人的角度进行成本效益分析和对安大略省5年预算影响分析.
主要成果:
- 一次性普遍的HCV查可能会发现更多的病例,并将更多的人与护理联系起来,尽管证据质量非常低.
- 这两种普遍查策略 (所有成年人和1945-1975年队列) 都比单独基于风险的查更便宜,更有效.
- 成本效益很高,100%的概率在每QALY获得的5万至10万美元的支付意愿门上.
结论:
- 扩大一次性HCV查提供了一个比单独基于风险的查更有效和更具成本效益的策略.
- 在安大略省,公共资助的普遍查预计将在5年内对预算产生重大影响.
- 患者的观点强调,需要扩大查范围,超越高风险群体,以便更早地诊断和治疗.
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