Hope Silvia F, Webster Jacqui, Trieu Kathy, Pillay Arti, Ieremia Merina, Bell Colin, Snowdon Wendy, Neal Bruce, Moodie Marj
Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Burwood, Victoria, Australia.
The George Institute for Global Health, Sydney, Australia.
PLoS One. 2017 Mar 29;12(3):e0173600. doi: 10.1371/journal.pone.0173600. eCollection 2017.
To summarise evidence describing the cost-effectiveness of population-based interventions targeting sodium reduction.
A systematic search of published and grey literature databases and websites was conducted using specified key words. Characteristics of identified economic evaluations were recorded, and included studies were appraised for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.
Twenty studies met the study inclusion criteria and received a full paper review. Fourteen studies were identified as full economic evaluations in that they included both costs and benefits associated with an intervention measured against a comparator. Most studies were modelling exercises based on scenarios for achieving salt reduction and assumed effects on health outcomes. All 14 studies concluded that their specified intervention(s) targeting reductions in population sodium consumption were cost-effective, and in the majority of cases, were cost saving. Just over half the studies (8/14) were assessed as being of 'excellent' reporting quality, five studies fell into the 'very good' quality category and one into the 'good' category. All of the identified evaluations were based on modelling, whereby inputs for all the key parameters including the effect size were either drawn from published datasets, existing literature or based on expert advice.
Despite a clear increase in evaluations of salt reduction programs in recent years, this review identified relatively few economic evaluations of population salt reduction interventions. None of the studies were based on actual implementation of intervention(s) and the associated collection of new empirical data. The studies universally showed that population-based salt reduction strategies are likely to be cost effective or cost saving. However, given the reliance on modelling, there is a need for the effectiveness of new interventions to be evaluated in the field using strong study designs and parallel economic evaluations.
总结描述以减少钠摄入为目标的人群干预措施成本效益的证据。
使用特定关键词对已发表文献数据库、灰色文献数据库及网站进行系统检索。记录已识别的经济评估的特征，并使用《卫生经济评估报告标准合并清单》（CHEERS清单）对纳入研究的报告质量进行评估。
20项研究符合研究纳入标准并接受全文审查。14项研究被确定为完整的经济评估，因为它们包括与对照措施相比的干预措施相关的成本和效益。大多数研究是基于实现减盐目标的情景进行的建模练习，并假定对健康结果有影响。所有14项研究均得出结论，其针对人群钠摄入量减少的特定干预措施具有成本效益，且在大多数情况下可节省成本。略超过一半的研究（8/14）被评估为报告质量“优秀”，5项研究属于“非常好”质量类别，1项属于“良好”类别。所有已识别的评估均基于建模，其中所有关键参数（包括效应量）的输入数据均来自已发表的数据集、现有文献或基于专家建议。
尽管近年来盐减少计划的评估明显增加，但本综述发现针对人群盐减少干预措施的经济评估相对较少。没有一项研究基于干预措施的实际实施及相关新实证数据的收集。这些研究普遍表明，基于人群的盐减少策略可能具有成本效益或可节省成本。然而，鉴于对建模的依赖，需要使用强有力的研究设计和并行经济评估在实地评估新干预措施的有效性。
