关于特定健康状况基于偏好的测量方法发展的文献系统综述。
A Systematic Review of the Literature on the Development of Condition-Specific Preference-Based Measures of Health.
作者信息
Goodwin Elizabeth, Green Colin
机构信息
Health Economics Group, University of Exeter Medical School, University of Exeter, Room 1.06, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK.
Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, University of Exeter, Exeter, UK.
出版信息
Appl Health Econ Health Policy. 2016 Apr;14(2):161-83. doi: 10.1007/s40258-015-0219-9.
BACKGROUND
Health state utility values (HSUVs) are required to calculate quality-adjusted life-years (QALYs). They are frequently derived from generic preference-based measures of health. However, such generic measures may not capture health attributes of relevance to specific conditions. In such cases, a condition-specific preference-based measure (CSPBM) may be more appropriate.
OBJECTIVE
This systematic review aimed to identify all published accounts of developing CSPBMs to describe and appraise the methods used.
METHOD
We undertook a systematic search (of Embase, MEDLINE, PsycINFO, Web of Science, the Cochrane Library, CINAHL, EconLit, ASSIA and the Health Management Information Consortium database) to identify published accounts of CSPBM development up to July 2015. Studies were reviewed to investigate the methods used to design classification systems, estimate HSUVs, and validate the measures.
RESULTS
A total of 86 publications were identified, describing 51 CSPBMs. Around two-thirds of these were QALY measures; the remainder were designed for clinical decision making only. Classification systems for 33 CSPBMs were derived from existing instruments; 18 were developed de novo. HSUVs for 34 instruments were estimated using a 'composite' approach, involving statistical modelling; the remainder used a 'decomposed' approach based on multi-attribute utility theory. Half of the papers that described the estimation of HSUVs did not report validating their measures.
CONCLUSION
Various methods have been used at all stages of CSPBM development. The choice between developing a classification system de novo or from an existing instrument may depend on the availability of a suitable existing measure, while the choice between a decomposed or composite approach appears to be determined primarily by the purpose for which the instrument is designed. The validation of CSPBMs remains an area for further development.
背景
计算质量调整生命年（QALYs）需要健康状态效用值（HSUVs）。它们通常源自基于偏好的通用健康测量方法。然而，此类通用测量方法可能无法涵盖与特定疾病相关的健康属性。在这种情况下，基于特定疾病偏好的测量方法（CSPBM）可能更为合适。
目的
本系统评价旨在识别所有已发表的关于开发CSPBMs的描述，并对所使用的方法进行描述和评估。
方法
我们进行了系统检索（检索Embase、MEDLINE、PsycINFO、Web of Science、Cochrane图书馆、CINAHL、EconLit、ASSIA和健康管理信息联盟数据库），以识别截至2015年7月已发表的关于CSPBM开发的描述。对研究进行综述，以调查用于设计分类系统、估计HSUVs和验证测量方法所使用的方法。
结果
共识别出86篇出版物，描述了51种CSPBMs。其中约三分之二是QALY测量方法；其余仅为临床决策而设计。33种CSPBMs的分类系统源自现有工具；18种是重新开发的。34种工具的HSUVs使用“综合”方法进行估计，涉及统计建模；其余使用基于多属性效用理论的“分解”方法。描述HSUVs估计的论文中有一半未报告对其测量方法进行验证。
结论
在CSPBM开发的各个阶段都使用了各种方法。重新开发分类系统还是从现有工具中开发分类系统的选择可能取决于是否有合适的现有测量方法，而分解方法或综合方法的选择似乎主要由工具设计的目的决定。CSPBMs的验证仍是一个有待进一步发展的领域。
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