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中国急性缺血性卒中人群药物经济学研究的系统评价
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| 篇名： | 中国急性缺血性卒中人群药物经济学研究的系统评价 |
| TITLE： | Systematic evaluation of pharmacoeconomic studies on acute ischemic stroke population in China |
| 摘要： | 目的 对基于中国急性缺血性卒中（AIS）人群的药物经济学研究（模型法）进行系统评价，为完善AIS药物经济学评价方法提供建议。方法计算机检索中国知网、万方数据知识服务平台、维普网、PubMed、Embase、theCochraneLibrary、ScienceDirect、WebofScience数据库，检索时限为2014年1月－2022年2月，搜集关于AIS药物经济学评价的相关文献，统计并分析纳入研究的基本信息、模型的基本信息以及结果指标。使用CHEERS2022清单对纳入文献的质量进行评价，找出现有文献中存在的问题并提出建议。结果最终纳入12篇文献，包括中文5篇、英文7篇。所有研究均报告了研究角度，主要为卫生体系角度；目标人群的年龄主要分布在60岁左右；纳入研究中的主要干预措施为药物治疗，包括单一用药方案和联合用药方案；9篇文献采用决策树联合Markov模型，3篇文献单独使用Markov模型，但健康状态的划分方式不一致；所有文献均报告了研究时限和循环周期，大多数研究选择的研究时限为30年，循环周期为1年；所有研究均采用改良Rankin量表评分作为临床效果指标，该数据主要来源于临床试验；大多数文献中的效用值来源于已发表的研究，成本主要为直接医疗成本；所有研究均进行了成本-效用分析，以质量调整生命年和（或）增量成本-效果比作为结局指标，并进行了单因素敏感性分析和概率敏感性分析，但未针对可能存在的不同模型结构进行情境分析。结论纳入研究的总体报告内容较为完整，但方法学较为单一，在研究角度、研究时限、参数来源、情境分析等方面仍存在不足。今后的AIS药物经济学评价应按照CHEERS清单条目进一步完善报告内容，从全社会角度出发，对多种健康状态划分方式进行情境分析，同时采用真实世界来源的数据，并规范研究结果的不确定性分析过程，以增加研究结果的真实性与可靠性。 |
| ABSTRACT： | OBJECTIVE To systematically evaluate pharmacoeconomic studies （modeling approach） based on the Chinese acute ischemic stroke （AIS） population， and to provide the suggestions for improving the pharmacoeconomic evaluation method of AIS. METHODS Retrieved from CNKI， Wanfang Data Knowledge Service Platform， VIP， PubMed， Embase， the Cochrane Library， ScienceDirect， and Web of Science databases， relevant literature on pharmacoeconomic evaluation of AIS were collected from January 2014 to February 2022. Basic information of included study， basic information and outcome indicators of the model were analyzed statistically. The quality of the included literature was evaluated using CHEERS 2022， and problems in the existing literature were identified and suggestions were made. RESULTS Twelve papers were finally included， involving five in Chinese and seven in English. All studies reported the study perspective， mainly from the perspective of health system； the age of the target population was mainly distributed around 60 years old； the main interventions in the included studies were pharmacotherapy， including single-drug regimens and combination drug regimens； nine papers used decision trees combined with Markov models， and three papers used Markov models alone， but the classification of health status was inconsistent； all papers reported study time frame and cycle period， with most studies choosing a study time frame of 30 years and a cycle period of 1 year； all studies used modified Rankin scale scores as an indicator of clinical effectiveness， which were mainly derived from clinical trials； utility values in most literature were derived from published studies， and costs were mainly direct medical costs； all studies performed cost-utility analyses using quality-adjusted life years and/or incremental cost-effectiveness ratios as outcome indicators， and single-factor sensitivity analyses and probabilistic sensitivity analyses were performed， but no contextual analyses were conducted for the different model structures that may exist. CONCLUSIONS The overall report of the included studies is relatively complete， but the methodology is relatively uniform， and there are still deficiencies in terms of study perspective， study time frame， parameter sources， and contextual analysis. Future AIS pharmacoeconomic evaluations should further improve the report content in accordance with the CHEERS list entries， conduct contextual analysis of multiple health state classification approaches from a society-wide perspective， while using data from real- world sources and standardizing the uncertainty analysis process of the study results to increase the authenticity and reliability of the study results. |
| 期刊： | 2023年第34卷第05期 |
| 作者： | 王琳；陈在余 |
| AUTHORS： | WANG Lin，CHEN Zaiyu |
| 关键字： | 急性缺血性卒中；药物经济学；模型；系统评价 |
| KEYWORDS： | acute ischemic stroke； pharmacoeconomics； model； systematic evaluation |
| 阅读数： | 129 次 |
| 本月下载数： | 5 次 |
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