Use of generic and condition-specific measures in NICE decision-making

卫生保健资源有限，需要确保这些资源得到有效利用。国家健康和临床卓越研究所(NICE)向NHS发布关于预防不良健康和促进良好健康的指导意见。它的部分工作包括评估新的保健技术(如药物)或方案(如减少吸烟流行)对健康的改善是否值得它们所需的额外资源。S首选的健康改善措施是质量调整后的生命年或质量年。这是一种寿命长度的衡量标准，由代表生命质量的值加权而成。对治疗对生活质量影响的评估通常基于向NICE提供的证据中与健康有关的生活质量的一般衡量标准。这些通用的衡量标准显示了治疗对健康的广泛层面的影响，这使得所有健康状况都可以使用相同的衡量标准。它们还纳入了普通人群关于不同水平或严重程度的健康对他们意味着什么的价值观。然而，这些与健康相关的生活质量指标并不总是包括在临床试验中，而且它们也因在某些情况下没有反映健康变化而受到批评。该项目将利用现有的研究，在NICE建议的分析范围内，使用针对特定健康状况制定的与健康有关的生活质量的衡量标准。它将确定与健康相关的生活质量的通用衡量标准是否不适用于某些疾病(如癌症)。它还将着眼于建立通用的生活质量衡量标准与特定条件的生活质量衡量标准之间的关系。该项目将确定扩大现有通用措施的方法，以更好地反映具体的健康状况或疾病。

Health-care resources are limited and there is a need to ensure these are used efficiently. The National Institute for Health and Clinical Excellence (NICE) issues guidance to the NHS on the prevention of ill health and the promotion of good health. Part of its work includes an assessment of whether improvements to health as a result of new health technologies (such as drugs) or programmes (such as to reduce the prevalence of smoking) are worth the additional resources they require. NICE?s preferred measure for improvements in health is the quality adjusted life year or ?QALY?. This is a measure of length of life weighted by a value representing the quality of that life. Assessments of the impact of treatments on quality of life are usually based on generic measures of health-related quality of life in the evidence provided to NICE. These generic measures show the impact of treatments on a broad range of dimensions of health which allows the same measure to be used for all health conditions. They also incorporate values from the general population about what different levels or severities of health would mean to them. However, these measures of health-related quality of life are not always included in clinical trials and they have also been criticised for not reflecting changes in health in some conditions. This project will draw upon existing research to use measures of health-related quality of life that have been developed for specific health conditions within the analyses recommended by NICE. It will establish whether the generic measures of health related quality of life are inappropriate for some conditions (such as cancer). It will also look at establishing the relationship between quality of life measures that are generic with those that are specific to conditions. The project will establish methods for extending the existing generic measures to better reflect specific health conditions or diseases.