Cost Utility Analysis of Screening for Diabetic Retinopathy by a Computerized Simulation Model

计算机模拟模型筛查糖尿病视网膜病变的成本效用分析

基本信息

批准号：
10672124
负责人：
OHSAWA Isao
金额：
$ 1.02万
依托单位：
Nagoya University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1998
资助国家：
日本
起止时间：
1998 至 1999
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10672124/
关键词：
diabetes mellitus diabetic retinopathy screening decision analysis clinical economics cost-utility analysis cost effectiveness quality of life

项目摘要

( 1 ) Cost utility analysisTo assess the efficiency of the periodic examinations of detecting diabetic retinopathy, a Markov decision analytic model was constructed to compare four detecting strategies : 6-, 12-, 24-, 36-month interval screenings. The clinical effect on quality of life was expressed as quality-adjusted life years (QALYs). The costs were estimated from medical charge lists of the health insurance system in Japan. Our model showed that screening strategies would reduce visual loss and improve quality of life in individuals and that the incremental cost-effectiveness ratio of 6-month interval strategy, 4,571,800 yen/QALYs, would be very high compared with 12-month interval strategy, 662,100 yen/QALYs. The estimation not only from insurer's viewpoint but also from societal viewpoint is necessary to the appropriate evaluation of the efficiency.( 2 ) Subjective health values of diabetic patientsWe examined preferences for current health states in hospitalized patients with d … More iabetes using the rating scale (RS) and the standard gamble (SG), and evaluated the relation between their utility values and the other characteristics. Age and diabetes duration were related to the RS scores. Diabetic states such as glycosylated hemoglobin levels, diabetic complications and daily insulin injections did not influence both the RS scores and the SG scores. The individuals who desired to extend their life rather than to relieve pain provided significant higher RS scores than those who did not desire. Of personality factors, extracted from personality questionnaires by factor analysis, the "steadiness" correlated modestly and "tendency to give up" correlated inversely with the SG scores. Current subjective health values among diabetic patients varied widely and did not relate well to their diabetic states. In clinical practice of diabetes, not only objective clinical indicators but also subjective health values for diabetic states should be fully incorporated into the process of clinical decision making. Less

（1）成本实用程序对检测糖尿病性视网膜病的周期性检查，用于比较四种检测策略：6-，12-，12-，24-，36个月间隔筛查。调整后的生活剧院（QALYS）是从日本的医疗系统中估算的。 - 月际涉及期日元/Qalys的估计不是保险公司的观点，而社会的估计也是对效率的适当评估。（SG），评估其效用和其他特征。，“稳定性”与SGGG螺钉相关的趋势与糖尿病的冰相关，不仅是对象指标，而且健康价值也应在临床决策过程中完全不良