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下一代测序/综合基因组分析的价值标准系统评价,为价值框架的制定提供信息。

A Systematic Review of Value Criteria for Next-Generation Sequencing/Comprehensive Genomic Profiling to Inform Value Framework Development.

机构信息

Health Technology Assessment and Health Economics Department, Institute for Clinical Effectiveness and Health Policy (IECS).

Medical Technology Research Group, London School of Economics (LSE).

出版信息

Value Health. 2024 May;27(5):670-685. doi: 10.1016/j.jval.2024.02.002. Epub 2024 Feb 23.

Abstract

OBJECTIVES

To comprehensively identify and map an exhaustive list of value criteria for the assessment of next-generation sequencing/comprehensive genomic profiling (NGS/CGP), to be used as an aid in decision making.

METHODS

We conducted a systematic review to identify existing value frameworks (VFs) applicable to any type of healthcare technology. VFs and criteria were mapped to a previously published Latin American (LA) VF to harmonize definitions and identify additional criteria and or subcriteria. Based on this analysis, we extracted a comprehensive, evidence-based list of criteria and subcriteria to be considered in the design of a NGS/CGP VF.

RESULTS

A total of 42 additional VFs were compared with the LA VF, 88% were developed in high-income countries, 30% targeted genomic testing, and 16% specifically targeted oncology. A total of 242 criteria and subcriteria were extracted; 227 (94%) were fully/partially included in the LA VF; and 15 (6%) were new. Clinical benefit and economic aspects were the most common criteria. VFs oriented to genomic testing showed significant overlap with other VFs. Considering all criteria and subcriteria, a total of 18 criteria and 36 individual subcriteria were identified.

CONCLUSIONS

Our study provides an evidence-based set of criteria and subcriteria for healthcare decision making useful for NGS/CGP as well as other health technologies. The resulting list can be beneficial to inform decision making and will serve as a foundation to co-create a multistakeholder NGS/CGP VF that is aligned with the needs and values of health systems and could help to improve patient access to high-value technologies.

摘要

目的

全面确定和绘制下一代测序/综合基因组分析(NGS/CGP)评估的详尽价值标准清单,作为决策辅助工具。

方法

我们进行了系统综述,以确定适用于任何类型医疗技术的现有价值框架(VF)。将 VF 和标准映射到以前发表的拉丁美洲(LA)VF 上,以协调定义并确定其他标准和/或子标准。基于此分析,我们提取了一个全面的、基于证据的标准和子标准清单,以考虑在 NGS/CGP VF 的设计中。

结果

共比较了 42 个额外的 VF 和 LA VF,88%是在高收入国家开发的,30%针对基因组测试,16%专门针对肿瘤学。共提取了 242 个标准和子标准;227 个(94%)完全/部分包含在 LA VF 中;15 个(6%)是新的。临床效益和经济方面是最常见的标准。针对基因组测试的 VF 与其他 VF 有显著重叠。考虑到所有标准和子标准,共确定了 18 个标准和 36 个子标准。

结论

我们的研究为医疗保健决策提供了一套基于证据的标准和子标准,适用于 NGS/CGP 以及其他健康技术。由此产生的清单有助于为决策提供信息,并将成为共同创建与卫生系统的需求和价值观保持一致的多方利益相关者 NGS/CGP VF 的基础,有助于改善患者获得高价值技术的机会。

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