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氟代硼二吡咯正电子发射断层扫描在阿尔茨海默病早期诊断中的应用:一项探索其潜在价值和关键数据缺口的离散事件模拟研究

Florbetaben PET in the Early Diagnosis of Alzheimer's Disease: A Discrete Event Simulation to Explore Its Potential Value and Key Data Gaps.

作者信息

Guo Shien, Getsios Denis, Hernandez Luis, Cho Kelly, Lawler Elizabeth, Altincatal Arman, Lanes Stephan, Blankenburg Michael

机构信息

United BioSource Corporation, Health Economics-Modeling and Simulation, 430 Bedford Street, Suite 300, Lexington, MA 02420, USA.

出版信息

Int J Alzheimers Dis. 2012;2012:548157. doi: 10.1155/2012/548157. Epub 2012 Dec 26.

Abstract

The growing understanding of the use of biomarkers in Alzheimer's disease (AD) may enable physicians to make more accurate and timely diagnoses. Florbetaben, a beta-amyloid tracer used with positron emission tomography (PET), is one of these diagnostic biomarkers. This analysis was undertaken to explore the potential value of florbetaben PET in the diagnosis of AD among patients with suspected dementia and to identify key data that are needed to further substantiate its value. A discrete event simulation was developed to conduct exploratory analyses from both US payer and societal perspectives. The model simulates the lifetime course of disease progression for individuals, evaluating the impact of their patient management from initial diagnostic work-up to final diagnosis. Model inputs were obtained from specific analyses of a large longitudinal dataset from the New England Veterans Healthcare System and supplemented with data from public data sources and assumptions. The analyses indicate that florbetaben PET has the potential to improve patient outcomes and reduce costs under certain scenarios. Key data on the use of florbetaben PET, such as its influence on time to confirmation of final diagnosis, treatment uptake, and treatment persistency, are unavailable and would be required to confirm its value.

摘要

对阿尔茨海默病(AD)生物标志物应用的日益了解,可能使医生能够做出更准确、更及时的诊断。氟比他班是一种用于正电子发射断层扫描(PET)的β淀粉样蛋白示踪剂,是这些诊断生物标志物之一。本分析旨在探讨氟比他班PET在疑似痴呆患者AD诊断中的潜在价值,并确定进一步证实其价值所需的关键数据。开展了一项离散事件模拟,从美国医保支付方和社会角度进行探索性分析。该模型模拟了个体疾病进展的终生过程,评估了从初始诊断检查到最终诊断的患者管理对其的影响。模型输入数据来自对新英格兰退伍军人医疗系统大型纵向数据集的特定分析,并辅以公共数据源数据和假设。分析表明,在某些情况下,氟比他班PET有改善患者预后和降低成本的潜力。关于氟比他班PET应用的关键数据,如它对最终诊断确认时间、治疗接受度和治疗持续性的影响,目前尚不可得,而这些数据是证实其价值所必需的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eab/3541641/23d7ad8f91c4/IJAD2012-548157.001.jpg

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