Expected wait times for access to a disease-modifying Alzheimer's treatment in the United States
Expected wait times for access to a disease-modifying Alzheimer's treatment in the United States
复制标题
DOI：
10.1002/alz.12470
复制
发表时间：
2021-09-27
影响因子：
14
通讯作者：
Hanson, Mark
中科院分区：
文献类型：
--
作者：
Mattke, Soeren;Hanson, Mark
2017年的一项研究分析了美国医疗保健系统提供疾病改善阿尔茨海默氏症治疗的准备情况，并预测了大量的等待时间。我们用改进的模型和更新的数据更新预测。方法该模型跟踪患者的初始评估，痴呆症专家的认知测试，验证性生物标志物测试和输注。初始评估后的所有步骤均假定为容量受限。有关求医行为的模型参数和假设来自已发表的文献和专家输入。结果：如果患者根据简短的认知测试转诊，专家就诊的等待时间将达到50个月左右。如果转诊还需要阳性的血液生物标志物检测，等待时间约为12个月。在这两种情况下，确证性生物标志物检测和输注治疗的等待时间将受到限制。讨论在初始评估时更好的诊断工具可以减少获得治疗的不必要的延误。
Introduction A 2017 study had analyzed the preparedness of the U.S. health care system to deliver a disease-modifying Alzheimer's treatment and predicted substantial wait times. We update the prediction with an improved model and newer data. Methods The model tracks patients from initial evaluation, cognitive testing by a dementia specialist, confirmatory biomarker testing, and infusion delivery. All steps after initial evaluation are assumed to be capacity constrained. Model parameters and assumptions about care-seeking behavior were derived from the published literature and expert input. Results If patients were referred based on a brief cognitive test, wait times for specialist visits would reach around 50 months. If referral also required a positive blood-based biomarker test, wait times would be around 12 months. In both scenarios, wait times for confirmatory biomarker testing and infusion treatment would be limited. Discussion Better diagnostic tools at initial evaluation may reduce unnecessary delays in access to treatment.