Fleurence Rachael L
Department of Health Sciences, York Trials Unit, University of York, Heslington York, UK.
Health Econ. 2007 Dec;16(12):1345-57. doi: 10.1002/hec.1225.
Setting priorities for research using economic in addition to scientific criteria can ensure that resources are spent efficiently and equitably.
This study applies two priority setting methods 'payback' and expected value of information (EVI) to two research areas (osteoporosis and pressure ulcers) and where appropriate to four clinical trials: the Record Trial, the Vitamin D and Calcium Trial and the Hip Protector Trial (osteoporosis), and the Pressure Trial (wound care).
Two decision-analytic models were developed. For 'payback', the PATHS model was used to estimate the expected net benefits of conducting the four clinical trials. An EVI framework was applied to estimate the cost-effectiveness of conducting further research in the two disease areas investigated.
The application of 'payback' suggests that the Record Trial and the Vitamin D and Calcium Trial would be cost-effective. The Hip Protector and the Pressure Ulcer Trial are cost-effective under certain assumptions concerning the likelihood of obtaining positive, negative or inconclusive results. The EVI method suggests that research would be potentially cost-effective in these areas in the populations considered.
EVI provides strategic information for setting priorities for research between disease areas and study populations. 'Payback' provides information on the cost-effectiveness of specific research designs. However, further work in this area, particularly concerning the issue of implementation of research, is required.
除了科学标准外，利用经济学标准确定研究优先级可确保资源得到有效且公平的使用。
本研究将两种优先级确定方法——“回报”法和信息期望值（EVI）法应用于两个研究领域（骨质疏松症和压疮），并在适当时应用于四项临床试验：记录试验、维生素D和钙试验以及髋部保护器试验（骨质疏松症），以及压力试验（伤口护理）。
开发了两个决策分析模型。对于“回报”法，使用PATHS模型来估计开展这四项临床试验的预期净效益。应用EVI框架来估计在两个所研究疾病领域开展进一步研究的成本效益。
“回报”法的应用表明，记录试验以及维生素D和钙试验具有成本效益。在关于获得阳性、阴性或不确定结果可能性的某些假设下，髋部保护器试验和压疮试验具有成本效益。EVI方法表明，在所考虑的人群中，这些领域的研究可能具有成本效益。
EVI为在疾病领域和研究人群之间确定研究优先级提供战略信息。“回报”法提供有关特定研究设计成本效益的信息。然而，该领域还需要进一步开展工作，特别是关于研究实施问题的工作。
