University of York, York, UK.
Br Med Bull. 2012;101:17-31. doi: 10.1093/bmb/lds003. Epub 2012 Feb 13.
INTRODUCTION/BACKGROUND: The quality-adjusted life year (QALY) is the preferred measure of health outcome used to inform decisions over the use of health care interventions in the UK NHS. This measure considers the overall impact of alternative interventions on both the quantity and quality of life.
Review of the relevant literature. Areas of agreement The QALY assumes that health improvement is equally valued between individuals. Areas of controversy Some can perceive as equitable, that is fair, the assumption that health improvement is equally valued between individuals in the QALY. However, others may believe that this assumption leaves no space for alternative views over equity to be explicitly considered in societal decision making.
The role of equity in decision making in the UK has been subject of intense debate, and controversy, and to-date there is no consensus on whether, or how, should NICE should change their general process.
Further examination of the issues needs to be debated and researched.
简介/背景：质量调整生命年（QALY）是英国国家卫生服务体系（NHS）中用于告知医疗干预措施使用决策的首选健康结果衡量标准。该衡量标准考虑了替代干预措施对生命数量和质量的整体影响。
对相关文献的综述。共识领域 QALY 假设健康改善在个人之间具有同等价值。争议领域 一些人可能认为，在 QALY 中，健康改善在个人之间具有同等价值是公平的、合理的。然而，其他人可能认为，这一假设没有为在社会决策中明确考虑公平的替代观点留出空间。
英国决策中的公平问题一直是激烈辩论和争议的主题，迄今为止，关于 NICE 是否应该改变其一般流程，或者应该如何改变，尚无共识。
需要进一步讨论和研究这些问题。
