Langfitt John, Wiebe Samuel
University of Rochester, New York 14642-8673, USA.
Epilepsia. 2002;43 Suppl 4:17-24. doi: 10.1046/j.1528-1157.43.s.4.4.x.
Economic evaluations aim to inform policy makers about the cost-effectiveness of different therapies so that limited health care resources may be allocated efficiently. For such evaluations, the effects of therapy must be captured by measures that are reliable, valid, and clinically meaningful. Mortality and changes in disease activity (e.g., seizure freedom, reduction in seizure frequency) may be reliable and valid, but their clinical meaning is not always apparent. Changes in widely used "quality-of-life" measures can quantify therapeutic effects, but the value of such changes to patients is not necessarily clear. This article reviews conceptual and methodological issues involved in determining the value of health effects in the context of economic evaluations of epilepsy therapies. Techniques for eliciting preferences for health effects are reviewed. The limited information on preferences for epilepsy-related health states is described. Directions for further research are suggested.
经济评估旨在为政策制定者提供不同治疗方法的成本效益信息，以便有限的医疗保健资源能够得到有效分配。对于此类评估，治疗效果必须通过可靠、有效且具有临床意义的指标来体现。死亡率和疾病活动的变化（如癫痫发作停止、发作频率降低）可能是可靠且有效的，但它们的临床意义并不总是显而易见。广泛使用的“生活质量”指标的变化可以量化治疗效果，但这些变化对患者的价值并不一定明确。本文综述了在癫痫治疗经济评估背景下确定健康影响价值所涉及的概念和方法问题。对引出健康影响偏好的技术进行了综述。描述了关于癫痫相关健康状态偏好的有限信息。并提出了进一步研究的方向。
