具有成本效益但临床不适用：新的 NICE 骨质疏松症干预阈值（技术评估 464）。
Cost-effective but clinically inappropriate: new NICE intervention thresholds in osteoporosis (Technology Appraisal 464).
机构信息
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK.
出版信息
Osteoporos Int. 2018 Jul;29(7):1511-1513. doi: 10.1007/s00198-018-4505-x. Epub 2018 Jun 8.
Abstract
PURPOSE
To comment on the latest technology appraisal of the National Institute for Clinical Excellence (NICE) in osteoporosis.
METHODS
Review of NICE Technology Appraisal (TA464) on bisphosphonate use in osteoporosis.
RESULTS
The NICE appraisal on bisphosphonate use in osteoporosis indicates that treatment with oral bisphosphonates may be instituted at a FRAX 10-year probability of major osteoporotic fracture above 1%. Implementation would mean that all women aged 50 years or older are deemed eligible for treatment, a position that would increase the burden of rare long-term side effects across the population.
CONCLUSION
Cost-effectiveness thresholds for low-cost interventions should not be used to set intervention thresholds but rather to validate the implementation of clinically driven intervention thresholds.
摘要
目的
评论英国国家卫生与临床优化研究所（NICE）最新发布的骨质疏松症技术评估报告。
方法
对 NICE 关于骨质疏松症中双磷酸盐使用的技术评估（TA464）进行综述。
结果
NICE 对骨质疏松症中双磷酸盐使用的评估表明，对于 FRAX 10 年主要骨质疏松性骨折概率大于 1%的患者，可开始使用口服双磷酸盐治疗。这意味着所有 50 岁或以上的女性都被认为有治疗适应证，这将增加在人群中发生罕见长期副作用的负担。
结论
不应使用低成本干预措施的成本效益阈值来设定干预阈值，而应验证临床驱动的干预阈值的实施。
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