Leal Jose, Khurshid Waqar, Pagano Eva, Feenstra Talitha
Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK.
Unit of Cancer Epidemiology, "Città della Salute e della Scienza" Hospital and CPO Piemonte, Piemonte, Italy.
BMJ Open. 2017 Oct 5;7(10):e014954. doi: 10.1136/bmjopen-2016-014954.
Diabetes is a major public health problem and prediabetes (intermediate hyperglycaemia) is associated with a high risk of developing diabetes. With evidence supporting the use of preventive interventions for prediabetes populations and the discovery of novel biomarkers stratifying the risk of progression, there is a need to evaluate their cost-effectiveness across jurisdictions. In diabetes and prediabetes, it is relevant to inform cost-effectiveness analysis using decision models due to their ability to forecast long-term health outcomes and costs beyond the time frame of clinical trials. To support good implementation and reimbursement decisions of interventions in these populations, models should be clinically credible, based on best available evidence, reproducible and validated against clinical data. Our aim is to identify recent studies on computer simulation models and model-based economic evaluations of populations of individuals with prediabetes, qualify them and discuss the knowledge gaps, challenges and opportunities that need to be addressed for future evaluations.
A systematic review will be conducted in MEDLINE, Embase, EconLit and National Health Service Economic Evaluation Database. We will extract peer-reviewed studies published between 2000 and 2016 that describe computer simulation models of the natural history of individuals with prediabetes and/or decision models to evaluate the impact of interventions, risk stratification and/or screening on these populations. Two reviewers will independently assess each study for inclusion. Data will be extracted using a predefined pro forma developed using best practice. Study quality will be assessed using a modelling checklist. A narrative synthesis of all studies will be presented, focussing on model structure, quality of models and input data, and validation status.
This systematic review is exempt from ethics approval because the work is carried out on published documents. The findings of the review will be disseminated in a related peer-reviewed journal and presented at conferences.
CRD42016047228.
糖尿病是一个主要的公共卫生问题，而糖尿病前期（中间高血糖状态）与患糖尿病的高风险相关。有证据支持对糖尿病前期人群采取预防干预措施，并且发现了能够对病情进展风险进行分层的新型生物标志物，因此有必要在不同司法管辖区评估其成本效益。在糖尿病和糖尿病前期中，使用决策模型进行成本效益分析具有重要意义，因为决策模型能够预测临床试验时间范围之外的长期健康结果和成本。为了支持对这些人群干预措施的良好实施和报销决策，模型应基于最佳可得证据具有临床可信度、可重复且能根据临床数据进行验证。我们的目的是识别关于糖尿病前期个体人群的计算机模拟模型以及基于模型的经济评估的近期研究，对其进行质量评定，并讨论未来评估需要解决的知识空白、挑战和机遇。
将在医学文献数据库（MEDLINE）、荷兰医学文摘数据库（Embase）、经济文献数据库（EconLit）和英国国家卫生服务经济评估数据库中进行系统综述。我们将提取2000年至2016年间发表的同行评审研究，这些研究描述了糖尿病前期个体自然史的计算机模拟模型和/或用于评估干预措施、风险分层和/或筛查对这些人群影响的决策模型。两名评审员将独立评估每项研究是否纳入。将使用根据最佳实践制定的预定义表格提取数据。将使用建模清单评估研究质量。将对所有研究进行叙述性综合，重点关注模型结构、模型和输入数据的质量以及验证状态。
本系统综述无需伦理批准，因为该工作是对已发表文献进行的。综述结果将在相关同行评审期刊上发表，并在会议上展示。
CRD42016047228。
