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个人效用和基因组测序在儿科和成人疾病中的应用:通过三个离散选择实验得出社会偏好。

The personal utility and uptake of genomic sequencing in pediatric and adult conditions: eliciting societal preferences with three discrete choice experiments.

机构信息

Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.

Australian Genomics Health Alliance, Melbourne, Australia.

出版信息

Genet Med. 2020 Aug;22(8):1311-1319. doi: 10.1038/s41436-020-0809-2. Epub 2020 May 6.

Abstract

PURPOSE

To estimate the personal utility and uptake of genomic sequencing (GS) across pediatric and adult-onset genetic conditions.

METHODS

Three discrete choice experiment (DCE) surveys were designed and administered to separate representative samples of the Australian public. Bayesian D-efficient explicit partial profile designs were used. Choice data were analyzed using a panel error component random parameter logit model.

RESULTS

Overall, 1913 participants completed the pediatric (n = 533), symptomatic adult (n = 700) and at-risk adult (n = 680) surveys. The willingness-to-pay for GS information in pediatric conditions was estimated at $5470-$15,250 (US$3830-$10,675) depending on the benefits of genomic information. Uptake ranged between 60% and 81%. For symptomatic adults, the value of GS was estimated at $1573-$8102 (US$1100-$5671) and uptake at 34-82%. For at-risk adults, GS was valued at $2036-$5004 (US$1425-$3503) and uptake was predicted at 35-61%.

CONCLUSION

There is substantial personal utility in GS, particularly for pediatric conditions. Personal utility increased as the perceived benefits of genomic information increased. The clinical and regulatory context, and individuals' sociodemographic and attitudinal characteristics influenced the value and uptake of GS. Society values highly the diagnostic, clinical, and nonclinical benefits of GS. The personal utility of GS should be considered in health-care decision-making.

摘要

目的

评估基因组测序(GS)在儿科和成人发病遗传疾病中的个人效用和接受程度。

方法

设计并向澳大利亚公众的三个代表性样本分别进行了三次离散选择实验(DCE)调查。使用贝叶斯 D 有效显式部分概况设计。使用面板误差分量随机参数对数模型分析选择数据。

结果

共有 1913 名参与者完成了儿科(n=533)、有症状成人(n=700)和高危成人(n=680)调查。根据基因组信息的收益,GS 信息在儿科疾病中的支付意愿估计为 5470-15250 美元(3830-10675 美元)。接受程度在 60%-81%之间。对于有症状的成年人,GS 的价值估计为 1573-8102 美元(1100-5671 美元),接受程度为 34-82%。对于高危成年人,GS 的价值估计为 2036-5004 美元(1425-3503 美元),预计接受程度为 35-61%。

结论

GS 具有很大的个人效用,特别是对于儿科疾病。随着基因组信息的预期收益增加,个人效用也随之增加。临床和监管背景以及个体的社会人口统计学和态度特征影响了 GS 的价值和接受程度。社会高度重视 GS 的诊断、临床和非临床益处。在医疗保健决策中应考虑 GS 的个人效用。

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