Padula William V, McQueen Robert Brett, Pronovost Peter J
*Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD †Center for Pharmaceutical Outcomes Research, Skaggs School of Pharmacy & Pharmaceutical Sciences, University of Colorado, Aurora, CO ‡Departments of Anesthesiology & Critical Care Medicine and Surgery, Johns Hopkins Medicine, Baltimore, MD.
Med Care. 2017 Nov;55(11):909-911. doi: 10.1097/MLR.0000000000000810.
The Second Panel on Cost-Effectiveness in Health and Medicine convened on December 7, 2016 at the National Academy of Medicine to disseminate their recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses (CEAs). Following its summary, panel proceedings included lengthy discussions including the field's struggle to disseminate findings efficiently through peer-reviewed literature to target audiences. With editors of several medical and outcomes research journals in attendance, there was consensus that findings of cost-effectiveness analyses do not effectively reach other researchers or health care providers. The audience members suggested several solutions including providing additional training to clinicians in cost-effectiveness research and requiring that cost-effectiveness models are made publicly available. However, there remains the questions of whether making economic modelers' work open-access through journals is fair under the defense that these models remain one's own intellectual property, or whether journals can properly manage the peer-review process specifically for cost-effectiveness analyses. In this article, we elaborate on these issues and provide some suggested solutions that may increase the dissemination and application of cost-effectiveness literature to reach its intended audiences and ultimately benefit the patient. Ultimately, it is our combined view as economic modelers and clinicians that cost-effectiveness results need to reach the clinician to improve the efficiency of medical practice, but that open-access models do not improve clinician access or interpretation of the economics of medicine.
第二届卫生与医学成本效益小组于2016年12月7日在国家医学院召开会议，以传播其关于成本效益分析（CEA）的开展、方法实践及报告的建议。在总结之后，小组会议进行了长时间讨论，包括该领域在通过同行评审文献向目标受众有效传播研究结果方面面临的困难。由于几家医学和结果研究期刊的编辑出席，大家达成共识，即成本效益分析的结果未能有效传达给其他研究人员或医疗服务提供者。与会者提出了几种解决方案，包括为临床医生提供更多成本效益研究方面的培训，以及要求公开成本效益模型。然而，仍然存在一些问题，比如通过期刊使经济建模者的工作开放获取在这些模型仍是个人知识产权的情况下是否公平，或者期刊能否专门为成本效益分析妥善管理同行评审过程。在本文中，我们详细阐述这些问题，并提供一些建议的解决方案，这些方案可能会增加成本效益文献的传播和应用，以惠及目标受众并最终使患者受益。最终，作为经济建模者和临床医生，我们共同认为成本效益结果需要传达给临床医生以提高医疗实践效率，但开放获取模型并不能改善临床医生获取或理解医学经济学的情况。
