Sculpher M, Michaels J, McKenna M, Minor J
Brunel University.
Int J Technol Assess Health Care. 1996 Winter;12(1):104-25. doi: 10.1017/s0266462300009430.
Despite the perception of many people that lasers represent the cutting edge of high-technology medicine, this form of medical technology has been subject to relatively little rigorous evaluation. This dearth of research relates particularly to economic evaluation, where there have been few attempts to justify the high cost of laser equipment. This paper details an economic evaluation of the use of laser technology as a secondary adjunct to angioplasty to treat peripheral arterial occlusions. Using data from a range of sources, including a published randomized trial, a cost-utility model is developed to estimate the costs and benefits of the laser, relative to standard angioplasty. The best available data indicate a cost-effective role for the laser, but important areas of uncertainty exist, including the laser's secondary recanalization rate, which has been estimated on the basis of limited numbers of patients. This uncertainty suggests that further research is required before widespread diffusion of the laser for use in this clinical context.
尽管许多人认为激光代表了高科技医学的前沿，但这种医学技术形式受到的严格评估相对较少。这种研究的匮乏尤其与经济评估相关，在经济评估方面，几乎没有人尝试证明激光设备的高昂成本是合理的。本文详细介绍了将激光技术用作血管成形术的辅助手段来治疗外周动脉闭塞的经济评估。利用包括已发表的随机试验在内的一系列来源的数据，开发了一个成本效用模型，以估计相对于标准血管成形术而言，激光的成本和效益。现有最佳数据表明激光具有成本效益的作用，但仍存在重要的不确定性领域，包括激光的二次再通率，该比率是根据有限数量的患者估算得出的。这种不确定性表明，在激光广泛应用于这一临床背景之前，还需要进一步的研究。
