Recommendations of the Panel on Cost-effectiveness in Health and Medicine.
Recommendations of the Panel on Cost-effectiveness in Health and Medicine.
复制标题
健康和医学成本效益小组的建议。
DOI：
10.1001/jama.1996.03540150055031
复制
发表时间：
1996
期刊：
影响因子：
--
通讯作者：
L. Russell
中科院分区：
文献类型：
--
作者：
M. Weinstein;J. Siegel;M. Gold;M. Kamlet;L. Russell
目的
为进行成本效益分析（CEA）制定基于共识的建议。这篇文章，第二个在一个3部分的系列，描述了构成参考案例分析的建议的基础上，开发的一套做法，以指导CEA通知社会资源分配决策，以及这些建议的内容。
参与者
健康和医学成本效益小组是一个非联邦小组，在CEA，临床医学，伦理学和健康结果测量方面具有专业知识，由美国公共卫生署（PHS）召集。
证据
小组审查了成本效益分析的理论基础、现行做法和分析中使用的替代方法。建议尽可能以理论为基础，但也考虑到道德和实用因素以及用户的需要。
共识过程
该小组通过两年半的讨论提出了建议。小组工作组准备的初稿征求了联邦政府方法学家、卫生机构官员和学术方法学家的意见。
结论
该小组的方法建议涉及：（1）属于成本效益（C/E）比率分子和分母的组成部分;（2）衡量C/E比率分子中的资源使用情况;（3）评估C/E比率分母中的健康后果;（4）估计干预措施的有效性;（5）纳入时间偏好和折扣;（6）处理不确定性。建议应遵循"理性规则“，在实践产生的负担与其对研究的重要性之间取得平衡。如果研究人员在CEA中遵循一套标准的方法，研究的质量和可比性以及它们的最终效用可以得到很大的改善。
OBJECTIVE
To develop consensus-based recommendations for the conduct of cost-effectiveness analysis (CEA). This article, the second in a 3-part series, describes the basis for recommendations constituting the reference case analysis, the set of practices developed to guide CEAs that inform societal resource allocation decisions, and the content of these recommendations.
PARTICIPANTS
The Panel on Cost-Effectiveness in Health and Medicine, a nonfederal panel with expertise in CEA, clinical medicine, ethics, and health outcomes measurement, was convened by the US Public Health Service (PHS).
EVIDENCE
The panel reviewed the theoretical foundations of CEA, current practices, and alternative methods used in analyses. Recommendations were developed on the basis of theory where possible, but tempered by ethical and pragmatic considerations, as well as the needs of users.
CONSENSUS PROCESS
The panel developed recommendations through 2 1/2 years of discussions. Comments on preliminary drafts prepared by panel working groups were solicited from federal government methodologists, health agency officials, and academic methodologists.
CONCLUSIONS
The panel's methodological recommendations address (1) components belonging in the numerator and denominator of a cost-effectiveness (C/E) ratio; (2) measuring resource use in the numerator of a C/E ratio; (3) valuing health consequences in the denominator of a C/E ratio; (4) estimating effectiveness of interventions; (5) incorporating time preference and discounting; and (6) handling uncertainty. Recommendations are subject to the ¿rule of reason,¿ balancing the burden engendered by a practice with its importance to a study. If researchers follow a standard set of methods in CEA, the quality and comparability of studies, and their ultimate utility, can be much improved.
影响因子：
3.5
作者：
Garber, AM;Phelps, CE
通讯作者：
Phelps, CE
影响因子：
3.4
作者：
Robert M Kaplan;John P. Anderson
通讯作者：
Robert M Kaplan;John P. Anderson