Giacomini Mita, Miller Fiona, Browman George
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
Int J Technol Assess Health Care. 2003 Spring;19(2):301-16. doi: 10.1017/s0266462303000278.
We describe an evaluation model to guide public coverage of new predictive genetic tests in Ontario, Canada. The model confronts common "gray zones" in evaluation and coverage policy for challenging new technologies. Analysis addresses three domains of the evaluation picture. The first specifies evaluative criteria (purpose, effectiveness, additional effects, unit cost, demand, cost-effectiveness). The second induces or deduces acceptable cutoffs for each criterion. The third domain addresses the need to make decisions under uncertainty and to respond to "gray" evaluations with conditional-coverage decisions. The evaluation criteria should be applied within sound decision-making processes.
我们描述了一种评估模型，以指导加拿大安大略省对新型预测性基因检测的公共覆盖范围。该模型应对了具有挑战性的新技术在评估和覆盖政策方面常见的“灰色地带”。分析涉及评估情况的三个领域。第一个领域规定了评估标准（目的、有效性、附加效果、单位成本、需求、成本效益）。第二个领域为每个标准推导或归纳出可接受的临界值。第三个领域解决在不确定性下做出决策的必要性，以及通过有条件覆盖决策来应对“灰色”评估的问题。评估标准应在合理的决策过程中应用。
