Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, Netherlands.
Institute for Medical Technology Assessment, Erasmus University, Rotterdam, Netherlands.
J Am Med Inform Assoc. 2020 Jul 1;27(9):1466-1475. doi: 10.1093/jamia/ocaa102.
Much has been invested in big data analytics to improve health and reduce costs. However, it is unknown whether these investments have achieved the desired goals. We performed a scoping review to determine the health and economic impact of big data analytics for clinical decision-making.
We searched Medline, Embase, Web of Science and the National Health Services Economic Evaluations Database for relevant articles. We included peer-reviewed papers that report the health economic impact of analytics that assist clinical decision-making. We extracted the economic methods and estimated impact and also assessed the quality of the methods used. In addition, we estimated how many studies assessed "big data analytics" based on a broad definition of this term.
The search yielded 12 133 papers but only 71 studies fulfilled all eligibility criteria. Only a few papers were full economic evaluations; many were performed during development. Papers frequently reported savings for healthcare payers but only 20% also included costs of analytics. Twenty studies examined "big data analytics" and only 7 reported both cost-savings and better outcomes.
The promised potential of big data is not yet reflected in the literature, partly since only a few full and properly performed economic evaluations have been published. This and the lack of a clear definition of "big data" limit policy makers and healthcare professionals from determining which big data initiatives are worth implementing.
为了改善健康状况和降低成本,人们在大数据分析方面投入了大量资金。然而,目前尚不清楚这些投资是否达到了预期目标。我们进行了范围界定综述,以确定大数据分析对临床决策的健康和经济影响。
我们在 Medline、Embase、Web of Science 和英国国家卫生服务经济评估数据库中搜索了相关文章。我们纳入了报告分析辅助临床决策的健康经济影响的同行评议论文。我们提取了经济方法并估计了影响,还评估了所用方法的质量。此外,我们还根据这一术语的广义定义,估计了有多少研究评估了“大数据分析”。
搜索结果为 12133 篇论文,但只有 71 篇研究完全符合所有入选标准。只有少数几篇论文是完整的经济评估;许多论文是在开发过程中进行的。论文经常报告医疗支付者的节省,但只有 20%的论文同时包括了分析成本。有 20 项研究检查了“大数据分析”,只有 7 项报告了成本节约和更好的结果。
大数据的预期潜力尚未在文献中得到体现,部分原因是仅发表了少数几篇完整且经过适当执行的经济评估。这一点以及“大数据”缺乏明确的定义,使得政策制定者和医疗保健专业人员无法确定哪些大数据计划值得实施。