Hartmann M, Knoth H, Schulz D, Knoth S
Faculty of Medicine, Friedrich-Schiller-University of Jena, Germany.
Br J Cancer. 2003 Oct 20;89(8):1405-8. doi: 10.1038/sj.bjc.6601308.
The purpose of this analysis of health economic studies in the field of oncology was to investigate among sponsored studies whether any relationship could be established between the type of sponsorship and (1) type of economic analysis, (2) health technology assessed, (3) sensitivity analysis performed, (4) publication status, and (5) qualitative conclusions about costs. The Health Economic Evaluations Database (HEED, version 1995-2000) was searched on the basis of oncological ICD-9 codes, sponsorship, and comparative studies. This search yielded a total of 150 eligible articles. Their evaluations were prepared independently by two investigators, on the basis of specific criteria. When evaluators disagreed, a third investigator provided a deciding evaluation. There was no statistically significant relationship between the type of sponsorship and sensitivity analysis performed (P=0.29) or publication status (P=0.08). However, we found a significant relationship between the types of sponsorship and of economic analysis (P=0.004), the health technology assessed (P<0.0001), and qualitative cost assessment (P=0.002). Studies with industrial sponsorship were 2.56 (99% lower confidence interval (CI)=1.28) times more likely to involve cost-minimisation analyses, were 0.04 (99% higher CI=0.39) times less likely to investigate diagnostic screening methods, and were 1.86 (99% lower CI=1.21) times more likely to reach positive qualitative conclusions about costs than studies supported by nonprofit organisations. In conclusion, our results suggest that there is a greater probability that industry-sponsored economic studies in the field of oncology tend to be cost-minimisation analyses, to investigate less likely diagnostic screening methods, and to draw positive qualitative conclusions about costs, as compared to studies supported by nonprofit organisations.
本肿瘤学领域卫生经济学研究分析的目的是,在受资助研究中调查资助类型与以下方面之间是否能建立任何关系:(1)经济分析类型;(2)评估的卫生技术;(3)进行的敏感性分析;(4)发表状态;(5)关于成本的定性结论。基于肿瘤学ICD - 9编码、资助情况和比较研究,对卫生经济评估数据库(HEED,1995 - 2000版)进行了检索。此次检索共得到150篇符合条件的文章。两名研究人员根据特定标准独立对这些文章进行评估。当评估人员意见不一致时,由第三名研究人员给出决定性评估。资助类型与进行的敏感性分析(P = 0.29)或发表状态(P = 0.08)之间无统计学显著关系。然而,我们发现资助类型与经济分析类型(P = 0.004)、评估的卫生技术(P < 0.0001)以及定性成本评估(P = 0.002)之间存在显著关系。与非营利组织资助的研究相比,有行业资助的研究进行成本最小化分析的可能性高2.56倍(99%置信区间下限(CI)= 1.28),研究诊断筛查方法的可能性低0.04倍(99%置信区间上限 = 0.39),得出关于成本的积极定性结论的可能性高1.86倍(99%置信区间下限 = 1.21)。总之,我们的结果表明,与非营利组织资助的研究相比,肿瘤学领域行业资助的经济研究更有可能进行成本最小化分析,研究不太可能的诊断筛查方法,并得出关于成本的积极定性结论。