York Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, YO10 5NQ, York, UK.
Medical Technologies Evaluation Programme, National Institute for Health and Care Excellence Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BT, UK.
Appl Health Econ Health Policy. 2023 Sep;21(5):689-700. doi: 10.1007/s40258-023-00811-x. Epub 2023 May 28.
myCOPD is a digital tool designed for people to manage their chronic obstructive pulmonary disease (COPD). It requires a device with an internet connection and incorporates tools for education, self-management, symptom tracking and pulmonary rehabilitation (PR). myCOPD was selected for medical technologies guidance by the UK National Institute for Health and Care Excellence (NICE) in 2020. The External Assessment Group (EAG) critiqued the company's submission. The evidence comprised four clinical studies (three randomised controlled trials [RCTs] and one observational study) and real-world evidence from 22 documents. The RCTs had small sample sizes, limiting the power to detect statistically significant differences and to match patient characteristics across arms. The company produced two de novo models for two subgroups of people with COPD; people discharged from hospital with acute exacerbation of COPD (AECOPD) and people referred for PR. After the EAG updated input parameters and adjusted the model structures, cost savings of £86,297 per clinical commissioning group (CCG) compared with standard care were estimated for the AECOPD population, with myCOPD predicted to be cost saving in 74% of iterations. Cost savings of £22,779 per CCG were estimated for the PR population (with the assumption that the CCG had an existing myCOPD licence), with myCOPD predicted to be cost saving in 86% of the iterations. The Medical Technologies Advisory Committee concluded that although myCOPD has the potential to help manage COPD in adults, further evidence is required to address uncertainties in the current evidence base. NICE published this as Medical Technology Guidance 68 (National Institute for Health and Care Excellence (NICE). myCOPD for managing chronic obstructive pulmonary disease. 2022. Available at: https://www.nice.org.uk/guidance/mtg68/ ).
myCOPD 是一款专为管理慢性阻塞性肺疾病(COPD)而设计的数字工具。它需要一个具备互联网连接的设备,并整合了教育、自我管理、症状跟踪和肺康复(PR)工具。2020 年,英国国家卫生与保健优化研究所(NICE)选择 myCOPD 进行医疗技术指导。外部评估小组(EAG)对公司的提交内容进行了评估。证据包括四项临床研究(三项随机对照试验[RCT]和一项观察性研究)和来自 22 份文件的真实世界证据。RCT 的样本量较小,限制了检测统计学显著差异和在各臂之间匹配患者特征的能力。该公司为两组 COPD 患者制作了两个全新的模型:从 COPD 急性加重中出院的患者和接受 PR 转诊的患者。在 EAG 更新输入参数并调整模型结构后,与标准护理相比,AECOPD 人群的预计成本节约为每个临床委托组(CCG)86297 英镑,myCOPD 在 74%的迭代中预计会有成本节约。PR 人群的预计成本节约为每个 CCG 22779 英镑(假设 CCG 已有 myCOPD 许可证),myCOPD 在 86%的迭代中预计会有成本节约。医疗技术咨询委员会得出结论,尽管 myCOPD 有可能帮助管理成年人的 COPD,但需要进一步的证据来解决当前证据基础中的不确定性。NICE 将其作为医疗技术指南 68 发布(英国国家卫生与保健优化研究所(NICE)。myCOPD 用于管理慢性阻塞性肺疾病。2022. 可在以下网址获得:https://www.nice.org.uk/guidance/mtg68/ )。
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