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孟加拉国疫苗引入的优先事项设定:一项多准则决策分析研究。

Priority setting of vaccine introduction in Bangladesh: a multicriteria decision analysis study.

机构信息

Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand.

Directorate General of Health Services, Government of Bangladesh Ministry of Health and Family Welfare, Dhaka, Bangladesh.

出版信息

BMJ Open. 2022 Feb 28;12(2):e054219. doi: 10.1136/bmjopen-2021-054219.

Abstract

OBJECTIVE

To prioritise vaccines for introduction in Bangladesh.

METHODS

Multicriteria decision analysis (MCDA) process was used to prioritise potential vaccines for introduction in Bangladesh. A set of criteria were identified, weighted and assigned scores by relevant stakeholders (n=14) during workshop A. The performance matrix of the data of vaccines against the criteria set was constructed and validated with the experts (n=6) in workshop B. The vaccines were ranked and appraised by another group of stakeholders (n=10) in workshop C, and the final workshop D involved the dissemination of the findings to decision-makers (n=28).

RESULTS

Five criteria including incidence rate, case fatality rate, vaccine efficacy, size of the population at risk and type of population at risk were used quantitatively to evaluate and to score the vaccines. Two other criteria, cost-effectiveness and outbreak potentiality, were considered qualitatively. On deliberation, the Japanese encephalitis (JE) vaccine was ranked top to be recommended for introduction in Bangladesh.

CONCLUSIONS

Based on the MCDA results, JE vaccine is planned to be recommended to the decision-makers for introduction into the national vaccine benefit package. The policymakers support the use of systematic evidence-based decision-making processes such as MCDA for vaccine introduction in Bangladesh, and to prioritise health interventions in the country.

摘要

目的

为孟加拉国优先选择疫苗。

方法

采用多准则决策分析(MCDA)流程对孟加拉国潜在疫苗进行优先排序。在 A 研讨会期间,相关利益攸关方(n=14)确定了一组标准,并对其进行了加权和评分。在 B 研讨会中,利用专家(n=6)对疫苗数据的标准矩阵进行了构建和验证。在 C 研讨会中,另一组利益攸关方(n=10)对疫苗进行了排名和评估,最后在 D 研讨会中向决策者(n=28)传播了研究结果。

结果

使用发病率、病死率、疫苗效力、风险人群规模和风险人群类型五个标准对疫苗进行定量评估和评分。另外两个标准,成本效益和爆发潜力,则被视为定性标准。经过讨论,日本脑炎(JE)疫苗被列为推荐在孟加拉国引入的首选疫苗。

结论

基于 MCDA 的结果,计划向决策者推荐 JE 疫苗纳入国家疫苗福利计划。政策制定者支持在孟加拉国使用系统的循证决策流程,如 MCDA,来为疫苗接种提供决策,并优先考虑该国的卫生干预措施。

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