Obtaining utility estimates of the health value of commonly prescribed treatments for asthma and depression.
Obtaining utility estimates of the health value of commonly prescribed treatments for asthma and depression.
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DOI：
10.1177/0272989x08315251
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发表时间：
2008-09
期刊：
影响因子：
--
通讯作者：
Rachelefsky G
中科院分区：
文献类型：
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作者：
Edelen MO;Burnam MA;Watkins KE;Escarce JJ;Huskamp H;Goldman HH;Rachelefsky G
比较成本和健康价值与替代质量改进工作是有用的。本研究采用专家小组方法，根据2种医疗条件下常用治疗模式的健康益处的0至1效用量表得出数值估计。该方法包括临床特征的开发和治疗获益估计的推导，通过治疗前后的效用评级的启发。临床概况规定了患者组的特征、待评定的治疗及其组合。一个由13名哮喘和抑郁症专家组成的小组对患有抑郁症或哮喘的成年患者组进行了一系列效用评级（在任何新的治疗之前，1或3个月后没有治疗，1或3个月后开始各种常见治疗）。小组召开会议讨论差异，随后做出最终评级。治疗获益估计值来自小组成员在小组会议后进行的评级。治疗获益估计值具有表面有效性和最小变异性，表明专家之间存在相当大的共识。抑郁症的治疗获益估计值范围为-0.03至0.25，哮喘的治疗获益估计值范围为-0.04至0.24。两种条件下的估计值变化极小（估计值的标准差范围为0.01至0.06）。在专家小组会议之前和之后对治疗获益估计值的比较表明，两者基本一致，有证据表明，两种健康状况的获益估计值具有可比性。可以使用专家小组方法从专家那里获得不同健康状况的治疗效益的可比估计数。
Comparing the costs and health value associated with alternative quality improvement efforts is useful. This study employs expert panel methodology to elicit numerical estimates based on a 0 to 1 utility scale of the health benefit of usual treatment patterns for 2 medical conditions. The approach includes development of clinical profiles and derivation of treatment benefit estimates via the elicitation of utility ratings before and after treatment. Clinical profiles specified characteristics of patient groups, treatments to be rated, and their combinations. A panel of 13 asthma and depression experts made a series of utility ratings (before any new treatment, 1 or 3 mo later with no treatment, 1 or 3 mo after initiating various common treatments) for adult patient groups with depression or asthma. The panel convened to discuss discrepancies and subsequently made final ratings. Treatment benefit estimates were derived from the ratings made by the panelists after the panel meeting. The treatment benefit estimates had face validity and minimal variability, indicating considerable consensus among experts. Treatment benefit estimates ranged from –0.03 to 0.25 for depression and from –0.04 to 0.24 for asthma. There was minimal variation in the estimates for both conditions (the estimates’ standard deviations ranged from 0.01 to 0.06). Comparisons of the treatment benefit estimates before and after the expert panel meeting indicated substantial convergence, and evidence suggests that the benefit estimates are comparable across the 2 health conditions. Comparable estimates of treatment benefit for distinct health conditions can be obtained from experts using the expert panel methodology.