Paddock Silvia, Brum Lauren, Sorrow Kathleen, Thomas Samuel, Spence Susan, Maulbecker-Armstrong Catharina, Goodman Clifford, Peake Michael, McVie Gordon, Geipel Gary, Li Rose
Rose Li and Associates, Inc., Bethesda, Maryland 20817, USA.
Prevention and Health Promotion, State of Hessen, 65187 Wiesbaden, Germany.
Ecancermedicalscience. 2015 Jan 7;9:498. doi: 10.3332/ecancer.2015.498. eCollection 2015.
Concerns about rising health care costs and the often incremental nature of improvements in health outcomes continue to fuel intense debates about 'progress' and 'value' in cancer research. In times of tightening fiscal constraints, it is increasingly important for patients and their representatives to define what constitutes 'value' to them. It is clear that diverse stakeholders have different priorities. Harmonisation of values may be neither possible nor desirable. Stakeholders lack tools to visualise or otherwise express these differences and to track progress in cancer treatments based on variable sets of values. The Patient Access to Cancer care Excellence (PACE) Continuous Innovation Indicators are novel, scientifically rigorous progress trackers that employ a three-step process to quantify progress in cancer treatments: 1) mine the literature to determine the strength of the evidence supporting each treatment; 2) allow users to weight the analysis according to their priorities and values; and 3) calculate Evidence Scores (E-Scores), a novel measure to track progress, based on the strength of the evidence weighted by the assigned value. We herein introduce a novel, flexible value model, show how the values from the model can be used to weight the evidence from the scientific literature to obtain E-Scores, and illustrate how assigning different values to new treatments influences the E-Scores. The Indicators allow users to learn how differing values lead to differing assessments of progress in cancer research and to check whether current incentives for innovation are aligned with their value model. By comparing E-Scores generated by this tool, users are able to visualise the relative pace of innovation across areas of cancer research and how stepwise innovation can contribute to substantial progress against cancer over time. Learning from experience and mapping current unmet needs will help to support a broad audience of stakeholders in their efforts to accelerate and maximise progress against cancer.
对医疗成本不断上升以及健康结果改善往往具有渐进性的担忧，继续引发了关于癌症研究中“进展”和“价值”的激烈辩论。在财政约束日益收紧的时代，患者及其代表明确对他们而言“价值”的构成要素变得越来越重要。显然，不同的利益相关者有不同的优先事项。价值的统一既不可能也不可取。利益相关者缺乏工具来直观呈现或以其他方式表达这些差异，以及基于不同的价值集来追踪癌症治疗的进展。卓越癌症护理患者可及性（PACE）持续创新指标是新颖的、科学严谨的进展追踪工具，采用三步流程来量化癌症治疗的进展：1）挖掘文献以确定支持每种治疗的证据强度；2）允许用户根据其优先事项和价值对分析进行加权；3）根据分配的价值加权后的证据强度计算证据分数（E值），这是一种追踪进展的新方法。我们在此介绍一种新颖、灵活的价值模型，展示如何使用该模型中的价值对科学文献中的证据进行加权以获得E值，并说明对新治疗赋予不同价值如何影响E值。这些指标使用户能够了解不同的价值如何导致对癌症研究进展的不同评估，并检查当前的创新激励措施是否与他们的价值模型一致。通过比较该工具生成的E值，用户能够直观呈现癌症研究各领域创新的相对速度，以及逐步创新如何随着时间的推移为抗击癌症取得重大进展做出贡献。从经验中学习并梳理当前未满足的需求，将有助于支持广大利益相关者加速并最大化抗击癌症进展的努力。
