Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Value Health. 2021 Mar;24(3):325-335. doi: 10.1016/j.jval.2020.12.006. Epub 2021 Feb 10.
Important links between dietary patterns and diseases have been widely applied to establish nutrition interventions. However, knowledge about between-person heterogeneity regarding the benefits of nutrition intervention can be used to personalize the intervention and thereby improve health outcomes and efficiency. We performed a systematic review of cost-effectiveness analyses (CEAs) of interventions with a personalized nutrition (PN) component to assess their methodology and findings.
A systematic search (March 2019) was performed in 5 databases: EMBASE, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar. CEAs involving interventions in adults with a PN component were included; CEAs focusing on clinical nutrition or undernutrition were excluded. The CHEERS checklist was used to assess the quality of CEAs.
We identified 49 eligible studies among 1792 unique records. Substantial variation in methodology was found. Most studies (91%) focused only on psychological concepts of PN such as behavior and preferences. Thirty-four CEAs were trial-based, 13 were modeling studies, and 4 studies were both trial- and model-based. Thirty-two studies used quality-adjusted life year as an outcome measure. Different time horizons, comparators, and modeling assumptions were applied, leading to differences in costs/quality-adjusted life years. Twenty-eight CEAs (49%) concluded that the intervention was cost-effective, and 75% of the incremental cost-utility ratios were cost-effective given a willingness-to-pay threshold of $50 000 per quality-adjusted life year.
Interventions with PN components are often evaluated using various types of models. However, most PN interventions have been considered cost-effective. More studies should examine the cost-effectiveness of PN interventions that combine psychological and biological concepts of personalization.
饮食模式与疾病之间的重要联系已广泛应用于建立营养干预措施。然而，了解营养干预措施对个体的益处的个体间差异，可以用于个性化干预，从而改善健康结果和效率。我们对具有个性化营养 (PN) 成分的干预措施的成本效益分析 (CEA) 进行了系统评价，以评估其方法和结果。
在 5 个数据库中进行了系统检索（2019 年 3 月）：EMBASE、Ovid 医学全文数据库、Web of Science、Cochrane 中心数据库和 Google Scholar。纳入了涉及成年人 PN 成分干预措施的 CEA；排除了专注于临床营养或营养不足的 CEA。使用 CHEERS 清单评估 CEA 的质量。
在 1792 条独特记录中，我们确定了 49 项符合条件的研究。研究方法存在很大差异。大多数研究（91%）仅关注 PN 的心理概念，如行为和偏好。34 项 CEA 是基于试验的，13 项是模型研究，4 项是基于试验和模型的研究。32 项研究使用质量调整生命年来作为结果衡量标准。不同的时间范围、比较器和建模假设被应用，导致成本/质量调整生命年的差异。28 项 CEA（49%）得出结论认为干预措施具有成本效益，并且在愿意支付每质量调整生命年 50000 美元的意愿支付阈值下，75%的增量成本效用比具有成本效益。
具有 PN 成分的干预措施通常使用各种类型的模型进行评估。然而，大多数 PN 干预措施已被认为具有成本效益。应进行更多研究来检验结合心理和生物个性化概念的 PN 干预措施的成本效益。
