Matza Louis S, Stewart Katie D, Davies Evan W, Hellmund Richard, Polonsky William H, Kerr David
Outcomes Research, Evidera, Bethesda, MD, USA.
Outcomes Research, Evidera, Bethesda, MD, USA.
Value Health. 2017 Mar;20(3):507-511. doi: 10.1016/j.jval.2016.10.007. Epub 2016 Dec 22.
Glucose monitoring is important for patients with diabetes treated with insulin. Conventional glucose monitoring requires a blood sample, typically obtained by pricking the finger. A new sensor-based system called "flash glucose monitoring" monitors glucose levels with a sensor worn on the arm, without requiring blood samples.
To estimate the utility difference between these two glucose monitoring approaches for use in cost-utility models.
In time trade-off interviews, general population participants in the United Kingdom (London and Edinburgh) valued health states that were drafted and refined on the basis of literature, clinician input, and a pilot study. The health states had identical descriptions of diabetes and insulin treatment, differing only in glucose monitoring approach.
A total of 209 participants completed the interviews (51.7% women; mean age = 42.1 years). Mean utilities were 0.851 ± 0.140 for conventional monitoring and 0.882 ± 0.121 for flash monitoring (significant difference between the mean utilities; t = 8.3; P < 0.0001). Of the 209 participants, 78 (37.3%) had a higher utility for flash monitoring, 2 (1.0%) had a higher utility for conventional monitoring, and 129 (61.7%) had the same utility for both health states.
The flash glucose monitoring system was associated with a significantly greater utility than the conventional monitoring system. This difference may be useful in cost-utility models comparing the value of glucose monitoring devices for patients with diabetes. This study adds to the literature on treatment process utilities, suggesting that time trade-off methods may be used to quantify preferences among medical devices.
血糖监测对于接受胰岛素治疗的糖尿病患者至关重要。传统的血糖监测需要采集血样，通常是通过手指采血获得。一种名为“动态葡萄糖监测”的新型基于传感器的系统，通过佩戴在手臂上的传感器监测血糖水平，无需采集血样。
评估这两种血糖监测方法在成本效用模型中的效用差异。
在时间权衡访谈中，英国（伦敦和爱丁堡）的普通人群参与者对基于文献、临床医生意见和一项试点研究拟定并完善的健康状态进行了评估。这些健康状态对糖尿病和胰岛素治疗的描述相同，仅在血糖监测方法上有所不同。
共有209名参与者完成了访谈（女性占51.7%；平均年龄 = 42.1岁）。传统监测的平均效用为0.851±0.140，动态监测的平均效用为0.882±0.121（平均效用之间存在显著差异；t = 8.3；P < 0.0001）。在209名参与者中，78名（37.3%）对动态监测的效用评价更高，2名（1.0%）对传统监测的效用评价更高，129名（61.7%）对两种健康状态的效用评价相同。
动态葡萄糖监测系统的效用显著高于传统监测系统。这种差异在比较糖尿病患者血糖监测设备价值的成本效用模型中可能有用。本研究补充了关于治疗过程效用的文献，表明时间权衡方法可用于量化对医疗设备的偏好。
