Estimated Monetary Value of Future Research Clarifying Uncertainties Around the Optimal Adult Hearing Screening Schedule.
Estimated Monetary Value of Future Research Clarifying Uncertainties Around the Optimal Adult Hearing Screening Schedule.
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DOI：
10.1001/jamahealthforum.2022.4065
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发表时间：
2022-11-04
期刊：
影响因子：
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通讯作者：
Sanders Schmidler, Gillian D
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作者：
Borre, Ethan D;Myers, Evan R;Dubno, Judy R;Emmett, Susan D;Pavon, Juliessa M;Francis, Howard W;Ogbuoji, Osondu;Sanders Schmidler, Gillian D
在美国，未来成人听力筛查研究的货币价值是多少？在这项基于模型的经济评估中，研究澄清了围绕最佳成人听力筛查时间表的所有不确定性，其价值在82亿至126亿美元之间。在美国投资82亿至126亿美元用于成人听力筛查的研究组合可能是对资源的良好利用。成人听力筛查并不常规进行，大多数听力损失（HL）患者从未在成年时进行过听力测试。预测未来研究的货币价值，澄清围绕最佳成人听力筛查时间表的不确定性。在本经济学评价中，使用经验证的HL决策模型（DeciBHAL-US：终生听力损失负担的决策模型）来模拟HL与听力筛查计划的当前检测和治疗。关键模型输入包括HL发病率（0.06%-10.42%/年）、助听器使用率（0.54%-8.14%/年）、筛查有效性（1.62 ×助听器使用率）、助听器的效用效益（+0.11）和助听器设备成本（3690美元）。分配了概率不确定性分析的模型参数分布。采用每质量调整生命年（QALY）10万美元的支付意愿，估计了完全信息期望值（EVPI）和部分完全信息期望值（EVPPI）。EVPI和EVPPI估计了未来研究的美元价值的上限。这项研究是基于40岁的人在他们的剩余寿命在美国初级保健环境。筛查时间表从45岁、55岁、65岁和75岁开始，频率为每1年或每5年。从卫生系统的角度来看，主要结果是季度和成本（2020美元）。从55岁至75岁开始每年筛查的平均增量成本效益比范围为39 200美元至80 200美元/QALY。在38%的概率不确定性分析模拟中，从55岁开始的年度筛查是最佳筛查时间表。人口EVPI（减少所有不确定性的价值）为82亿至126亿美元，根据支付意愿而有所不同，而EVPPI（减少所有筛查有效性不确定性的价值）为24亿美元。在美国成人听力筛查的经济评估中，确定了最佳成人听力筛查时间表的较大不确定性。听力筛查的未来研究具有很高的潜在价值，因此可能是合理的。这项经济评估项目的货币价值，未来的研究澄清周围的最佳成人听力筛查时间表的不确定性。
What is the monetary value of future research on adult hearing screening in the US? In this model-based economic evaluation, the value of research clarifying all uncertainties around the optimal adult hearing screening schedule was found to be between $8.2 and $12.6 billion. Investing up to $8.2 to $12.6 billion in a research portfolio on adult hearing screening in the US is likely a good use of resources. Adult hearing screening is not routinely performed, and most individuals with hearing loss (HL) have never had their hearing tested as adults. To project the monetary value of future research clarifying uncertainties around the optimal adult hearing screening schedule. In this economic evaluation, a validated decision model of HL (DeciBHAL-US: Decision model of the Burden of Hearing loss Across the Lifespan) was used to simulate current detection and treatment of HL vs hearing screening schedules. Key model inputs included HL incidence (0.06%-10.42%/y), hearing aid uptake (0.54%-8.14%/y), screening effectiveness (1.62 × hearing aid uptake), utility benefits of hearing aids (+0.11), and hearing aid device costs ($3690). Distributions to model parameters for probabilistic uncertainty analysis were assigned. The expected value of perfect information (EVPI) and expected value of partial perfect information (EVPPI) using a willingness to pay of $100 000 per quality-adjusted life-year (QALY) was estimated. The EVPI and EVPPI estimate the upper bound of the dollar value of future research. This study was based on 40-year-old persons over their remaining lifetimes in a US primary care setting. Screening schedules beginning at ages 45, 55, 65, and 75 years, and frequencies of every 1 or 5 years. The main outcomes were QALYs and costs (2020 US dollars) from a health system perspective. The average incremental cost-effectiveness ratio for yearly screening beginning at ages 55 to 75 years ranged from $39 200 to $80 200/QALY. Yearly screening beginning at age 55 years was the optimal screening schedule in 38% of probabilistic uncertainty analysis simulations. The population EVPI, or value of reducing all uncertainty, was $8.2 to $12.6 billion varying with willingness to pay and the EVPPI, or value of reducing all screening effectiveness uncertainty, was $2.4 billion. In this economic evaluation of US adult hearing screening, large uncertainty around the optimal adult hearing screening schedule was identified. Future research on hearing screening has a high potential value so is likely justified. This economic evaluation projects the monetary value of future research clarifying uncertainties around the optimal adult hearing screening schedule.