Path Finder: A Health Economics Evaluation of Visual Cues as a means to Reduce Falls in Parkinson's

英国国民健康保险制度每年花费约23亿英镑用于治疗跌倒。跌倒是由多种原因造成的，包括神经系统疾病，如帕金森氏症。帕金森氏症的一种症状叫做“冻僵”，患者会突然感觉像粘在地板上一样，无法移动。这通常发生在走路中间，是不稳定和跌倒的主要原因，导致高达70%的帕金森患者跌倒。跌倒会导致严重的伤害，如髋部骨折，在某些情况下甚至可能导致死亡。Path Finder通过投射视觉线索，减少了人们冻结的时间和频率。该设备挂在用户的鞋子上，并在每只相对的脚前投射一条绿色激光线。这触发了行走，帮助使用者更加流畅和独立地行走。我们提议的项目将开始评估该设备在NHS中的临床成本效益。我们将从一家NHS医院的小规模研究开始，开始收集数据，以支持该设备的成本效益。然后，我们将与NICE合作，批判性地分析我们迄今为止的证据。这将被用来帮助规划我们的路线，以出售到NHS。Path Finder自2017年6月起在整个欧洲经济区（EEA）上市。我们主要直接向客户销售，也通过一些经销商销售。然而，向NHS等医疗保健系统销售将是我们最大的收入来源。目前，像英国国民健康保险制度这样的医疗保健系统还没有一个好的解决帕金森症患者跌倒和冻结的办法。拐杖和框架用于支撑，但它们可能笨重，使它们在寒冷和家中（最常发生寒冷）时难以操作。人们也会使用物理疗法，虽然它很有效，但有70%的不遵守率，这意味着人们不做锻炼。因此，它成为一种昂贵且无效的解决方案。Path Finder提供了一种新的方法来缓解帕金森病的一种特定症状，这种症状已被证明是导致该人群跌倒的主要原因。因此，探路者在减少跌倒以及随之而来的人力和经济成本方面有着巨大的希望。

Every year the NHS spends around £2.3 billion on falls. Falls are due to a variety of reasons including neurological conditions such as Parkinson's disease. A symptom of Parkinson's called 'freezing' causes sufferers to suddenly feel as if glued to the floor and unable to move. This often happens mid walk and is a major cause for instability and falls, leading to up to 70% of falls in Parkinson's. Falls can lead to serious injuries such as hip fractures, or in some cases they may even cause death. Path Finder reduces the time spent freezing as well as how often a person freezes, by projecting visual cues. The device hooks over the users shoes and projects a greenlaser line in front of each opposing foot. This triggers walking and helps the user to walk more fluidly and independently.Our proposed project will begin to assess the clinical cost effectiveness of the device in the NHS. We will commence with a small scale study in a NHS hospital to start gathering data to support the cost effectiveness of the device. We will then work with NICE to critically analyse our evidence to date. This will be used to help plan our route to sell into the NHS. Path Finder has been on the market throughout the European Economic Area (EEA) since June 2017. We sell mainly directly to customers and through some distributors. Selling into healthcare systems such as the NHS, however, will be our biggest source of revenue.Currently, healthcare systems such as the NHS do not have a single good solution to falls and freezing in Parkinson's disease. Walking canes and frames are used for support, but they can be bulky, making them hard to maneuver when freezing and when in the home (where freezing most often occurs). Physiotherapy is also used, and although it can be effective, it carries a 70% non-compliance rate, meaning that people do not do their exercises. As such, it becomes an expensive and ineffective solution.Path Finder offers a new method to alleviate a specific symptom in Parkinson's disease, which has been demonstrated to cause the majority of falls for this population. As such, Path Finder holds great promise in reducing falls and the human and economic costs that follow.