Developing better economic models of osteoporosis: considerations for the calculation of the relative risk of fracture.
Developing better economic models of osteoporosis: considerations for the calculation of the relative risk of fracture.
复制标题
开发更好的骨质疏松症经济模型：计算骨折相对风险的考虑因素。
作者：
D. Black;L. Palermo;D. Grima
目的
模拟模型经常被用来评估骨质疏松症治疗的成本效益。许多成本效益分析关注的是一般人群的一个子集，如高风险患者。由于分析对假定的骨折风险非常敏感，因此比率必须准确反映指定目标人群的骨折风险。本研究的目的是描述方法上的困难，并提出一些可能的解决方案，用于计算目标人群的骨折风险。
方法
对于二元风险因素，描述了从具有风险因素的人相对于没有风险因素的人的相对风险（RR）转换为目标人群与一般人群相比的RR的方法。对于连续的风险因素（即，骨矿物质密度[BMD]），数据通常以每SD降低的骨折RR提供。与一般人群相比，在低于一定BMD阈值的人群中，将每SD降低的RR转换为RR的方法。
结果
这些结果应允许未来的经济模型，更准确地将现有的知识的风险因素，通过引入方法来计算骨折风险估计在目标人群。
结论
它说明了在计算目标人群的RR时，考虑一般人群中风险因素的患病率的重要性。
OBJECTIVE
Simulation models are often used to assess cost-effectiveness of osteoporosis therapies. Many cost-effectiveness analyses are interested in a subset of the general population, such as high-risk patients. As the analyses are very sensitive to the assumed risk of fracture, it is imperative that the rates accurately reflect the fracture risk in the specified target population. The objective of this study was to describe the methodological difficulties and present some possible solutions for calculating the risk of fracture in target populations of interest.
METHODS
For binary risk factors, a method for converting from a relative risk (RR) for people with a risk factor relative to those without, to an RR in the target population compared with the general population, is described. For continuous risk factors (i.e., bone mineral density [BMD]), data are often provided as an RR of fracture per SD decrease. A method for converting from an RR per SD decrease to an RR in those below a certain BMD threshold, compared with the general population, is presented.
RESULTS
These results should allow future economic models to more accurately incorporate existing knowledge of risk factors by introducing methods to calculate fracture risk estimates in a target population.
CONCLUSION
It illustrates the importance of considering the prevalence of risk factors in the general population when calculating RR in a target population.
影响因子：
158.5
作者：
CUMMINGS, SR;NEVITT, MC;VOGT, TM
通讯作者：
VOGT, TM