评价包括人类免疫缺陷病毒(HIV)感染者在内的人群中宫颈癌控制政策有效性和成本效益的数学模型:范围综述。
Mathematical Models for Evaluating Effectiveness and Cost-Effectiveness of Cervical Cancer Control Policies in Populations Including Women Living With Human Immunodeficiency Virus: A Scoping Review.
机构信息
Center of Excellence in Decision-Analytic Modeling and Health Economics Research, sitem-insel, Bern, Switzerland; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, USA.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
出版信息
Value Health Reg Issues. 2022 Nov;32:39-46. doi: 10.1016/j.vhri.2022.07.001. Epub 2022 Sep 2.
OBJECTIVES
Mathematical modeling is increasingly used to inform cervical cancer control policies, and model-based evaluations of such policies in women living with human immunodeficiency virus (HIV) are an emerging research area. We did a scoping review of published literature to identify research gaps and inform future work in this field.
METHODS
We systematically searched literature up to April 2022 and included mathematical modeling studies evaluating the effectiveness or cost-effectiveness of cervical cancer prevention strategies in populations including women living with HIV. We extracted information on prevention strategies and modeling approaches.
RESULTS
We screened 1504 records and included 22 studies, almost half of which focused on South Africa. We found substantial between-study heterogeneity in terms of strategies assessed and modeling approaches used. Fourteen studies evaluated cervical cancer screening strategies, 7 studies assessed human papillomavirus vaccination (with or without screening), and 1 study evaluated the impact of HIV control measures on cervical cancer incidence and mortality. Thirteen conducted cost-effectiveness analyses. Markov cohort state-transition models were used most commonly (n = 12). Most studies (n = 17) modeled the effect of HIV by creating HIV-related health states. Thirteen studies performed model calibration, but 11 did not report the calibration methods used. Only 1 study stated that model code was available upon request.
CONCLUSIONS
Few model-based evaluations of cervical cancer control strategies have specifically considered women living with HIV. Improvements in model transparency, by sharing information and making model code publicly available, could facilitate the utility of these evaluations for other high disease-burden countries, where they are needed for assisting policy makers.
目的
数学建模越来越多地用于为宫颈癌防控政策提供信息,对艾滋病毒(HIV)感染者中此类政策的基于模型的评估是一个新兴的研究领域。我们对已发表的文献进行了范围综述,以确定该领域的研究空白并为未来的工作提供信息。
方法
我们系统地检索了截至 2022 年 4 月的文献,并纳入了评估包括 HIV 感染者在内的人群中宫颈癌预防策略有效性或成本效益的数学建模研究。我们提取了预防策略和建模方法的信息。
结果
我们筛选了 1504 篇记录,纳入了 22 项研究,其中近一半的研究集中在南非。我们发现,在所评估的策略和使用的建模方法方面,研究之间存在很大的异质性。14 项研究评估了宫颈癌筛查策略,7 项研究评估了人乳头瘤病毒(HPV)疫苗接种(有或没有筛查),1 项研究评估了 HIV 控制措施对宫颈癌发病率和死亡率的影响。13 项研究进行了成本效益分析。最常用的是马尔可夫队列状态转移模型(n=12)。大多数研究(n=17)通过创建与 HIV 相关的健康状态来模拟 HIV 的影响。13 项研究进行了模型校准,但 11 项研究没有报告所使用的校准方法。只有 1 项研究表示模型代码可根据要求提供。
结论
很少有基于模型的宫颈癌防控策略评估专门考虑了 HIV 感染者。通过共享信息和公开模型代码,可以提高模型的透明度,从而促进这些评估在其他高疾病负担国家的应用,这些国家需要这些评估来协助决策者。
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