Cantor S B, Clover R D, Thompson R F
Department of Family Medicine, University of Texas Medical Branch at Galveston 77555-0853.
Am J Public Health. 1994 Jul;84(7):1144-8. doi: 10.2105/ajph.84.7.1144.
The risks and benefits of postexposure rabies prophylaxis were analyzed from clinical and economic perspectives. A decision-analytic model was constructed by using probability and outcome data from the literature and the state health department. Health outcomes were measured in quality-adjusted life years. In the base case (overweight adult male), treatment is optimal when the probability of animal rabidity is greater than 1 in 2000. Sensitivity analysis showed robustness in the treatment decision; however, the incremental cost-effectiveness ratio ($140,000/quality-adjusted life year) is sensitive to the rabidity probability. Treatment is optimal from the patient's perspective; however, it may not be cost-effective when the probability of rabidity is low.
从临床和经济角度分析了暴露后狂犬病预防的风险和益处。利用文献和州卫生部门的概率及结果数据构建了一个决策分析模型。健康结果以质量调整生命年衡量。在基础案例（超重成年男性）中，当动物患狂犬病的概率大于2000分之一时，治疗是最优选择。敏感性分析表明治疗决策具有稳健性；然而，增量成本效益比（140,000美元/质量调整生命年）对狂犬病概率敏感。从患者角度看治疗是最优的；然而，当狂犬病概率较低时，治疗可能不具有成本效益。
