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马尔可夫模型和分区生存模型会导致不同的结果吗?癌症治疗近期经济证据的综述。

Will the Markov model and partitioned survival model lead to different results? A review of recent economic evidence of cancer treatments.

机构信息

School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, People's Republic of China.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2021 Jun;21(3):373-380. doi: 10.1080/14737167.2021.1893167. Epub 2021 Mar 11.

Abstract

: Balancing the high cost of treatment brought about by new therapies has become a problem that needs to be considered. Cost-effectiveness analysis (CEA) is a commonly used method that provides information on the potential value of new cancer treatments. The Markov and partitioned survival (PS) models are commonly used. Whether the results differ between the models in empirical research and the methodological differences remain unclear.: A review was conducted to identify Canadian Agency for Drugs and Technologies in Health (CADTH) reports and papers published during the past 5 years that reported full economic evaluations of cancer treatments and used both models. In the included studies, most results except one obtained using the two models did not significantly differ.: Not enough evidence could support that there existed relevant bias in empirical studies about the PS model, and more methodological research and application of empirical research should be performed. We recommended that when individual data are available and the model structure is not complicated, the PS model is more appropriate. Both the PS and Markov models are recommended to assess model structure uncertainty.

摘要

: 新疗法带来的高昂治疗成本已成为一个需要考虑的问题。成本效益分析(CEA)是一种常用的方法,可提供有关新癌症治疗方法潜在价值的信息。常用的模型有马尔可夫模型和分区生存模型(PS)。在实证研究中,模型之间的结果是否存在差异以及方法学差异尚不清楚。: 本研究旨在确定加拿大药物和技术评估机构(CADTH)在过去 5 年内发布的报告和论文,这些报告和论文均报道了癌症治疗的全经济评估,并同时使用了这两种模型。在纳入的研究中,除了一个结果外,使用两种模型得到的大多数结果均无显著差异。: 没有足够的证据表明 PS 模型的实证研究存在相关偏差,应该进行更多的方法学研究和实证研究应用。我们建议在有个体数据且模型结构不复杂的情况下,PS 模型更为适用。建议使用 PS 和马尔可夫模型来评估模型结构不确定性。

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