Nuijten Mark
Ars Accessus Medica BV, Amsterdam, The Netherlands.
Nestle Nutr Inst Workshop Ser. 2015;82:129-41. doi: 10.1159/000382009. Epub 2015 Oct 20.
The objective of this paper is to describe the applications of health economic theory to medical nutrition.
The published literature provides evidence that medical nutrition, e.g. oral nutritional supplements, is an effective treatment for patients with disease related malnutrition. Malnutrition is associated with mortality risk and complication rates, including infections. Malnutrition is not a new problem and with an ageing population it continues to become a major public health concern as increasing age is associated with an increased risk of malnutrition.
This overview shows that in the case RCTs are providing the clinical evidence, there is no methodological difference between a cost-effectiveness analysis for pharmaceutical or nutrition. However, in nutrition the evidence may not always come from RCT data, but will be more often based on observational data. Therefore the clinical evidence of nutrition in itself is not the issue, but the handling of clinical evidence from observational studies. As the link between the consumption of a food product and a resulting health status is often more difficult to establish than the effect of a drug treatment it requires the further development of adapted methodologies in order to correctly predict the impact of food-related health effects and health economic outcomes from a broader perspective.
本文旨在描述健康经济理论在医学营养中的应用。
已发表的文献表明，医学营养，如口服营养补充剂，是治疗疾病相关性营养不良患者的有效方法。营养不良与死亡风险及并发症发生率相关，包括感染。营养不良并非新问题，随着人口老龄化，它持续成为主要的公共卫生问题，因为年龄增长与营养不良风险增加相关。
本综述表明，在随机对照试验提供临床证据的情况下，药物或营养的成本效益分析在方法上并无差异。然而，在营养领域，证据可能并非总是来自随机对照试验数据，而更多地基于观察性数据。因此，营养本身的临床证据并非问题所在，而是观察性研究临床证据的处理。由于确定食品消费与健康状况之间的联系通常比药物治疗的效果更难，所以需要进一步开发适用的方法，以便从更广泛的角度正确预测与食品相关的健康影响和健康经济结果的影响。
