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定义精准肿瘤学经济评估的核心数据集。

Defining a Core Data Set for the Economic Evaluation of Precision Oncology.

机构信息

Canadian Centre for Applied Research in Cancer Control, Cancer Control Research, BC Cancer, Vancouver, Canada.

Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, England, UK; Oxford NIHR Biomedical Research Centre, Oxford, England, UK.

出版信息

Value Health. 2022 Aug;25(8):1371-1380. doi: 10.1016/j.jval.2022.01.005. Epub 2022 Feb 23.

Abstract

OBJECTIVES

Precision oncology is generating vast amounts of multiomic data to improve human health and accelerate research. Existing clinical study designs and attendant data are unable to provide comparative evidence for economic evaluations. This lack of evidence can cause inconsistent and inappropriate reimbursement. Our study defines a core data set to facilitate economic evaluations of precision oncology.

METHODS

We conducted a literature review of economic evaluations of next-generation sequencing technologies, a common application of precision oncology, published between 2005 and 2018 and indexed in PubMed (MEDLINE). Based on this review, we developed a preliminary core data set for informal expert feedback. We then used a modified-Delphi approach with individuals involved in implementation and evaluation of precision medicine, including 2 survey rounds followed by a final voting conference to refine the data set.

RESULTS

Two authors determined that variation in published data elements was reached after abstraction of 20 economic evaluations. Expert consultation refined the data set to 83 unique data elements, and a multidisciplinary sample of 46 experts participated in the modified-Delphi process. A total of 68 elements (81%) were selected as required, spanning demographics and clinical characteristics, genomic data, cancer treatment, health and quality of life outcomes, and resource use.

CONCLUSIONS

Cost-effectiveness analyses will fail to reflect the real-world impacts of precision oncology without data to accurately characterize patient care trajectories and outcomes. Data collection in accordance with the proposed core data set will promote standardization and enable the generation of decision-grade evidence to inform reimbursement.

摘要

目的

精准肿瘤学产生了大量的多组学数据,以改善人类健康并加速研究。现有的临床研究设计和相关数据无法为经济评估提供比较证据。这种证据的缺乏可能导致不一致和不适当的报销。我们的研究定义了一个核心数据集,以促进精准肿瘤学的经济评估。

方法

我们对 2005 年至 2018 年间在 PubMed(MEDLINE)索引中发表的下一代测序技术(精准肿瘤学的常见应用)的经济评估进行了文献回顾。基于这项回顾,我们为非正式专家反馈开发了一个初步的核心数据集。然后,我们使用改良 Delphi 方法,让参与精准医学实施和评估的个人参与其中,包括 2 轮调查和最后一次投票会议,以完善数据集。

结果

两名作者在提取 20 项经济评估后,确定发表的数据元素存在差异。专家咨询将数据集精炼至 83 个独特的数据元素,共有 46 名专家参与了改良 Delphi 过程。共有 68 个元素(81%)被选为必需元素,涵盖人口统计学和临床特征、基因组数据、癌症治疗、健康和生活质量结果以及资源利用。

结论

如果没有数据准确描述患者护理轨迹和结果,成本效益分析将无法反映精准肿瘤学的实际影响。按照建议的核心数据集进行数据收集将促进标准化,并能够生成决策级证据,为报销提供信息。

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