Robinson R
Institute for Health Policy Studies, University of Southampton.
BMJ. 1993 Sep 25;307(6907):793-5. doi: 10.1136/bmj.307.6907.793.
When different health care interventions are not expected to produce the same outcomes both the costs and the consequences of the options need to be assessed. This can be done by cost-effectiveness analysis, whereby the costs are compared with outcomes measured in natural units--for example, per life saved, per life year gained, and per pain or symptom free day. Many cost-effective analyses rely on existing published studies for effectiveness data as it is often too costly or time consuming to collect data on cost and effectiveness during a clinical trial. Where there is uncertainty about the costs and effectiveness of procedures sensitivity analysis can be used, which examines the sensitivity of the results to alternative assumptions about key variables. In this article Ray Robinson describes these methods of analysis and discusses possibilities for how the benefits of alternative interventions should be valued.
当不同的医疗保健干预措施预期不会产生相同的结果时，就需要评估这些选择的成本和后果。这可以通过成本效益分析来完成，即把成本与以自然单位衡量的结果进行比较——例如，每挽救一条生命、每获得一个生命年，以及每无痛或无症状的天数。许多成本效益分析依赖已发表的现有研究获取有效性数据，因为在临床试验期间收集成本和有效性数据往往成本过高或耗时过长。如果对程序的成本和有效性存在不确定性，可以使用敏感性分析，它会检验结果对关键变量的替代假设的敏感性。在本文中，雷·罗宾逊描述了这些分析方法，并讨论了如何评估替代干预措施的益处的可能性。
