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有更年期症状女性进行体育活动的成本效益:一项随机对照试验的结果

Cost-effectiveness of physical activity among women with menopause symptoms: findings from a randomised controlled trial.

作者信息

Kolu Päivi, Raitanen Jani, Nygård Clas-Håkan, Tomás Eija, Luoto Riitta

机构信息

UKK Institute for Health Promotion; Tampere, Finland.

UKK Institute for Health Promotion; Tampere, Finland; School of Health Sciences, University of Tampere; Tampere, Finland.

出版信息

PLoS One. 2015 Aug 10;10(8):e0135099. doi: 10.1371/journal.pone.0135099. eCollection 2015.

Abstract

Menopause is a period that may predispose one to a decrease in muscle strength, cardiorespiratory fitness, and quality of life. A study was carried out to evaluate the cost-effectiveness of physical activity among women displaying symptoms of menopause. The cost-effectiveness analysis was based on data from a six-month randomised controlled trial (n = 151). The women in the intervention group engaged in an unsupervised session of at least 50 minutes of physical activity four times a week. The control group continued their physical activity as before. An incremental cost-effectiveness ratio (ICER) was calculated in terms of maximal oxygen consumption, lean muscle mass, and quality-adjusted life years (QALYs) gained. A bootstrap technique was utilised to estimate uncertainty around the point estimate for ICER associated with the intervention. The mean total cost in the intervention group was €1,307 (SEM: €311) and in the control group was €1,253 (SEM: €279, p = 0.10) per person. The mean intervention cost was €208 per person. After six months of the behaviour-change intervention, the ICER was €63 for a 1 ml/kg/min improvement in cardiorespiratory fitness, the additional cost per one-gram increase in lean muscle mass was €126, and the cost per QALY gained was €46. According to the findings, physical activity among menopausal women was cost-effective for cardiorespiratory fitness, for lean muscle mass, and for QALYs gained, since the intervention was more effective than the actions within the control group and the additional effects of physical activity were gained at a very low price. From the societal perspective, the intervention used may promote ability to work and thereby save on further costs associated with early retirement or disability pension if the physical-activity level remains at least the same as during the intervention.

摘要

更年期是一个可能使人易出现肌肉力量下降、心肺功能减退和生活质量降低的时期。一项研究旨在评估有更年期症状的女性进行体育活动的成本效益。成本效益分析基于一项为期六个月的随机对照试验(n = 151)的数据。干预组的女性每周进行四次无监督的体育活动,每次至少50分钟。对照组则继续像以前一样进行体育活动。根据最大摄氧量、瘦肌肉量和获得的质量调整生命年(QALY)计算增量成本效益比(ICER)。采用自助法技术来估计与干预相关的ICER点估计值周围的不确定性。干预组的人均总费用为1307欧元(标准误:311欧元),对照组为1253欧元(标准误:279欧元,p = 0.10)。人均干预成本为208欧元。经过六个月的行为改变干预后,心肺功能每提高1毫升/千克/分钟的ICER为63欧元,瘦肌肉量每增加一克的额外成本为126欧元,每获得一个QALY的成本为46欧元。根据研究结果,更年期女性进行体育活动在改善心肺功能、增加瘦肌肉量和获得QALY方面具有成本效益,因为干预比对照组的行为更有效,而且体育活动的额外效果是以非常低的成本获得的。从社会角度来看,如果体育活动水平至少保持与干预期间相同,所采用的干预措施可能会提高工作能力,从而节省与提前退休或残疾抚恤金相关的进一步成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b51/4530885/cb5a2191860c/pone.0135099.g001.jpg

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