Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Value Health. 2011 Jul-Aug;14(5 Suppl 1):S51-9. doi: 10.1016/j.jval.2011.05.010.
To describe the development and validation of a health economic model (HEM) to address the tobacco disease burden and the cost-effectiveness of smoking cessation interventions (SCI) in seven Latin American countries.
The preparatory stage included the organization of the research network, analysis of availability of epidemiologic data, and a survey to health decision makers to explore country-specific information needs. The development stage involved the harmonization of a methodology to retrieve local relevant parameters and develop the model structure. Calibration and validation was performed using a selected country dataset (Argentina 2005). Predicted event rates were compared to the published rates used as model inputs. External validation was undertaken against epidemiologic studies that were not used to provide input data.
Sixty-eight decision makers were surveyed. A microsimulation HEM was built considering the availability and quality of epidemiologic data and relevant outcomes conceived to suit the identified information needs of decision makers. It considers all tobacco-related diseases (i.e., heart, cerebrovascular and chronic obstructive pulmonary disease, pneumonia/influenza, lung cancer, and nine other neoplasms) and can incorporate individual- and population-level interventions. The calibrated model showed all simulated event rates falling within ± 10% of the sources (-9%-+5%). External validation showed a high correlation between published data and model results.
This evidence-based, internally and externally valid HEM for the assessment of the effects of smoking and SCIs incorporates a broad spectrum of tobacco related diseases, SCI, and benefit measures. It could be a useful policy-making tool to estimate tobacco burden and cost-effectiveness of SCI.
描述一个健康经济模型（HEM）的开发和验证，以解决七个拉丁美洲国家的烟草疾病负担和戒烟干预（SCI）的成本效益问题。
准备阶段包括研究网络的组织、流行病学数据可用性的分析以及对卫生决策制定者的调查，以探索特定国家的信息需求。开发阶段涉及协调检索本地相关参数和开发模型结构的方法。使用选定的国家数据集（阿根廷 2005 年）进行校准和验证。预测事件率与用作模型输入的已发表率进行比较。针对未用于提供输入数据的流行病学研究进行外部验证。
对 68 位决策者进行了调查。构建了一个考虑到流行病学数据的可用性和质量以及为满足决策者确定的信息需求而设计的相关结果的微观模拟 HEM。它考虑了所有与烟草相关的疾病（即心脏病、脑血管病和慢性阻塞性肺疾病、肺炎/流感、肺癌和其他 9 种肿瘤），并可以纳入个体和人群干预措施。校准后的模型显示所有模拟事件率均在来源的±10%范围内（-9%-+5%）。外部验证表明，发表数据与模型结果之间具有高度相关性。
该基于证据、内部和外部有效的 HEM 用于评估吸烟和 SCI 的影响，纳入了广泛的与烟草相关的疾病、SCI 和效益衡量标准。它可以成为一种有用的决策制定工具，用于估计烟草负担和 SCI 的成本效益。
