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检验医学设备的准确性与有效性之间的关联:运用欧盟卫生技术评估(EUnetHTA)核心模型通过测量糖化血红蛋白(HbA1c)来比较两台分析仪。

Links between accuracy and effectiveness of laboratory medicine equipment: use of the EUnetHTA core model to compare two analyzers by measuring HbA1c.

作者信息

Di Resta Chiara, Sacco Chiara, Trbos Mladen, Locatelli Massimo, Banfi Giuseppe, Tomaiuolo Rossella

机构信息

Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy.

Laboratory Medicine Service, IRCCS Ospedale San Raffaele, Milan, Italy.

出版信息

Int J Technol Assess Health Care. 2024 Dec 3;40(1):e67. doi: 10.1017/S0266462324000497.

Abstract

OBJECTIVES

In the field of Laboratory Medicine, the evolution of knowledge and the innovation of technologies are the basis of analytical and diagnostic progress, leading to the development of new solutions based on innovative technologies. However, these advances must be accompanied by evidence of appropriateness, diagnostic effectiveness, and organizational efficiency, considering the test's first impact on patient outcomes.

METHODS

The Health Technology Assessment (HTA) is a valid management tool to support Laboratory Medicine professionals in assessing technologies and which is the most appropriate to adopt. This study is an illustrative case of the application of HTA, exploiting the EUnetHTA Core Model, on two analyzers able to determine the glycated hemoglobin (Hemoglobin A1c, HbA1c), the Capillarys 2 Flex piercing analyzer and the HLC-723G11 analyzer in the Laboratory Medicine Service of the IRCCS San Raffaele Hospital (Milan, IT). The main focus is related to potential differences in methods, organizational aspects, and clinical effectiveness of these approaches for measuring HbA1c.

RESULTS

The EUnetHTA Core Model has proven to be the optimal method for HTA in the field of Laboratory Medicine, as it allows to highlight both the peculiarities of the methods on which the analyzers are based and the clinical efficacy of the laboratory test on specific patient populations, considering individual variations in treatment responses, assessing the potential benefits for individual patients or small groups.

CONCLUSIONS

This granular analysis helps provide insights into the effectiveness and value of healthcare interventions at the patient level, contributing to evidence-based decision-making in clinical practice and healthcare policy.

摘要

目标

在检验医学领域,知识的演进和技术的创新是分析和诊断进步的基础,推动了基于创新技术的新解决方案的发展。然而,考虑到检测对患者预后的首要影响,这些进展必须伴有适用性、诊断有效性和组织效率的证据。

方法

卫生技术评估(HTA)是一种有效的管理工具,可支持检验医学专业人员评估技术以及哪种技术最适合采用。本研究是一个应用HTA的示例,利用欧盟卫生技术评估网络(EUnetHTA)核心模型,对意大利米兰圣拉斐尔科学研究所医院检验医学科的两款能够测定糖化血红蛋白(血红蛋白A1c,HbA1c)的分析仪——Capillarys 2 Flex穿刺分析仪和HLC - 723G11分析仪进行评估。主要关注点在于这些测定HbA1c方法在方法、组织方面和临床有效性上的潜在差异。

结果

事实证明,EUnetHTA核心模型是检验医学领域HTA的最佳方法,因为它既能突出分析仪所基于方法的特点,又能考虑到治疗反应的个体差异,评估特定患者群体的实验室检测临床疗效,以及对个体患者或小群体的潜在益处。

结论

这种细致的分析有助于深入了解患者层面医疗干预的有效性和价值,为临床实践和卫生保健政策中的循证决策提供依据。

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