Methodological issues in the economic analysis of cancer treatments
Methodological issues in the economic analysis of cancer treatments
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DOI：
10.1016/j.ejca.2006.08.010
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发表时间：
2006-11-01
影响因子：
8.4
通讯作者：
Hummel, Silvia
中科院分区：
文献类型：
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作者：
Tappenden, Paul;Chilcott, Jim;Hummel, Silvia
成本效益分析可适用于构成癌症服务的所有干预措施，包括筛查方案和早期治疗、诊断检测和转诊程序、手术、放疗、化疗和姑息治疗。在现有的癌症干预模型中已经采用了许多方法。然而，并非所有方法都是平等的;不适当的建模方法可能会使成本效益结果产生偏差。决策分析建模良好做法的通用指南为严格评估成本效益模型提供了有用的基础，但需要明确考虑一系列癌症特有的问题，以避免成本效益结果的偏差。这些癌症特异性问题包括：与疾病进展后转移性疾病的计划外治疗相关的相关成本和健康影响的适当表示，长期结局和临床试验资源的适当外推，关于试验持续时间以外事件风险函数性质的假设，以及替代结局和最终结局之间的关系。(c)2006爱思唯尔有限公司保留所有权利。
Cost-effectiveness analysis may be applied to the full range of interventions that make up a cancer service, including screening programmes and early treatments, diagnostic test and referral processes, surgery, radiotherapy, chemotherapy and palliative care. Numerous methodologies have been employed within existing models of cancer interventions. However, not all methodologies are equal; inappropriate modelling approaches may bias cost-effectiveness results. Generic guidelines for good practice in decision-analytic modelling provide a useful basis for critically appraising cost-effectiveness models, yet explicit consideration of a range of cancer-specific issues is required to avoid bias in cost-effectiveness results. These cancer-specific issues include the appropriate representation of relevant costs and health effects associated with unplanned treatments for metastatic disease administered beyond disease progression, the appropriate extrapolation of long-term outcomes and resources from clinical trials, assumptions concerning the nature of the event hazard function beyond the duration of the trial, and relationships between surrogate outcomes and final outcomes. (c) 2006 Elsevier Ltd. All rights reserved.