Schweitzer S O
Health Serv Res. 1974 Spring;9(1):22-32.
A methodological framework for the cost-effectiveness evaluation of diagnostic tests for mass screening is presented. The decision rule is based on disease incidence, probabilities of test error, the cost of the test and of treatment for found cases, and the economic value (expected lifetime earnings or equivalent) of additional length or quality of life for those cured of the disease. The decision rule is applied to the Pap test for cervical cancer, with results showing that as a one-time screening device the test is cost-effective from society's standpoint. Extensions of the method would permit estimation of the disease incidence at which a given test or treatment would be cost-effective; would permit estimation of the breakeven price of test and treatment with given disease incidence; and would allow determination of optimal testing frequency.
本文提出了一种用于大规模筛查诊断测试成本效益评估的方法框架。决策规则基于疾病发病率、测试误差概率、测试成本和确诊病例的治疗成本，以及治愈疾病者因生命延长或生活质量提高所带来的经济价值（预期终身收入或等效值）。该决策规则应用于宫颈癌巴氏试验，结果表明，从社会角度来看，作为一次性筛查手段，该试验具有成本效益。该方法的扩展将能够估计给定测试或治疗具有成本效益时的疾病发病率；能够在给定疾病发病率的情况下估计测试和治疗的收支平衡价格；并能够确定最佳测试频率。
