Impact of the U.S. panel on cost-effectiveness in health and medicine.

Impact of the U.S. panel on cost-effectiveness in health and medicine.
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美国专家组对健康和医学成本效益的影响。

DOI:
10.1016/s0749-3797(01)00409-3
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发表时间:
2002
影响因子:
5.5
通讯作者:
Chen,JamesL
Chen,JamesL
中科院分区:
医学2区
文献类型:
--
作者:
Phillips,KathrynA;Chen,JamesL

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目的研究美国卫生和医学成本效益小组(小组报告)提出的建议是否与成本效益分析方式的变化有关。方法:我们研究了在专家组报告发布后发表并引用了专家组报告的研究是否比(1)在专家组报告发布前发表的研究和(2)在专家组报告发布后发表但未引用专家组报告的研究更有可能遵循其关于贴现、质量调整生命年(QALYs)和增量比率的建议。我们使用科学引文索引来确定引用专家组报告的所有研究,这些研究也是经验性的成本效益分析(n=18)。我们随机选择两组进行比较(N=54)。使用列联表对研究进行比较。引用专家组报告的研究使用3%贴现率的研究明显多于报告后比较研究(p=0.03)和报告前比较研究(p=0.03)。引用专家组报告的研究更有可能使用质量年和增量比率(p=0.11至p=0.20),这一趋势不显著。结论:我们发现了专家组报告对实践产生影响的证据。然而,31%引用专家组报告的研究没有遵循使用3%贴现率的建议,只有28%的研究同时遵循了三项建议。
ObjectiveTo examine whether recommendations made by the U.S. Panel on Cost-Effectiveness in Health and Medicine (Panel Report) have been associated with changes in how cost-effectiveness analyses are conducted.MethodsWe examined whether studies published after the Panel Report was issued and which cited the Panel Report were more likely to follow its recommendations on discounting, quality-adjusted life years (QALYs), and incremental ratios than (1) studies published before the Panel Report, and (2) studies published after the Panel Report but that did not cite the Panel Report. We used the Science Citation Index to identify all studies citing the Panel Report that were also empirical, cost-effectiveness analyses (n=18). We randomly selected two groups for comparison (N=54). Studies were compared using contingency tables.ResultsSignificantly more studies that cited the Panel Report used a 3% discount rate than did post-report comparison studies (p=0.03) and pre-report comparison studies (p=0.03). There was a nonsignificant trend for studies citing the Panel Report to be more likely to use QALYs and incremental ratios (range of p=0.11 to p=0.20).ConclusionsWe found evidence that the Panel Report had an impact on practice. However, 31% of the studies citing the Panel Report did not follow the recommendation to use a 3% discount rate, and only 28% followed all three recommendations.
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