Stason W B
Harvard School of Public Health, Boston, MA 02115.
Am Heart J. 1990 Mar;119(3 Pt 2):718-24; discussion 724. doi: 10.1016/s0002-8703(05)80051-1.
The principles of cost-effectiveness analysis are straightforward and can be applied to set priorities among competing uses for resources. This article examines the relationship between serum cholesterol and coronary heart disease (CHD) risk, drawing on information from a number of large intervention trials. The cost-effectiveness of treatment alternatives for elevated serum cholesterol, hypertension, and symptomatic CHD are compared. Concern is expressed that the guidelines issued by the National Cholesterol Education Program extend beyond the available evidence and do not adequately take into account problems with adherence to diet and drug regimens or the cost of widespread implementation. The cost-effectiveness of drug treatment for both high cholesterol and hypertension depends on the populations at which they are targeted.
成本效益分析的原则很简单，可用于在相互竞争的资源使用中确定优先事项。本文利用多项大型干预试验的信息，研究血清胆固醇与冠心病（CHD）风险之间的关系。比较了血清胆固醇升高、高血压和有症状冠心病的治疗替代方案的成本效益。有人担心，国家胆固醇教育计划发布的指南超出了现有证据的范围，没有充分考虑饮食和药物治疗方案的依从性问题或广泛实施的成本。高胆固醇和高血压药物治疗的成本效益取决于其针对的人群。
