Petrou Stavros
Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
Cost Eff Resour Alloc. 2022 Mar 3;20(1):10. doi: 10.1186/s12962-022-00345-4.
Cost-utility analysis remains the preferred form of economic evaluation for health technology assessment, pricing and reimbursement authorities in several countries. The results of cost-utility analyses are commonly expressed in terms of incremental cost per quality-adjusted life year (QALY) gained where the QALY combines length of life and health-related quality of life in a single metric. This commentary provides an overview of key methodological challenges surrounding QALY estimation for paediatric economic evaluation. These challenges include issues surrounding the relevant attributes to incorporate into measurement instruments, appropriate respondents for the measurement and valuation tasks, perspectives adopted when completing valuation tasks, potential sources of bias in the description and valuation processes, and the paucity of psychometric evidence for existing measures. In addition, the commentary considers methodological challenges raised by research aimed at assessing whether a QALY gain by a child should be valued equally to a QALY gain by an adult.
成本效用分析仍是几个国家卫生技术评估、定价和报销部门进行经济评估时首选的形式。成本效用分析的结果通常以每获得一个质量调整生命年（QALY）的增量成本来表示，其中QALY将生命长度和与健康相关的生活质量结合在一个单一指标中。本评论概述了儿科经济评估中QALY估计所面临的关键方法挑战。这些挑战包括围绕纳入测量工具的相关属性、测量和估值任务的合适受访者、完成估值任务时采用的视角、描述和估值过程中潜在的偏差来源，以及现有测量方法缺乏心理测量学证据等问题。此外，该评论还考虑了旨在评估儿童获得的一个QALY增益是否应与成人获得的一个QALY增益同等估值的研究所提出的方法挑战。
