Sassi F, McKee M, Roberts J A
London School of Economics and Political Science.
Int J Technol Assess Health Care. 1997 Fall;13(4):613-30. doi: 10.1017/s0266462300010084.
The principles of economic evaluation are increasingly accepted by clinicians and policy makers as evidence from a significant number of studies becomes available to support their decisions. However, methods of assessment still need to be improved. This paper reports a comprehensive review of methodological challenges in the economic evaluation of diagnostic technology, where such challenges are more evident. This review formed the basis for a prioritized research agenda, with four main areas: modeling techniques for dealing with complexity; measures of the opportunity cost of shared resources; techniques for eliciting decision makers' utility functions for diagnostic tests; and ways of assessing the robustness of decisions. A number of methodological solutions are proposed, aimed at capturing elements and relationships that are usually neglected and fully recognizing the presence of an inductive cognitive component in decision-making processes.
随着大量研究的证据可用于支持临床医生和政策制定者的决策，经济评估原则越来越被他们所接受。然而，评估方法仍需改进。本文报告了对诊断技术经济评估中方法学挑战的全面综述，这些挑战在诊断技术经济评估中更为明显。该综述构成了一个优先研究议程的基础，该议程有四个主要领域：处理复杂性的建模技术；共享资源机会成本的度量；引出决策者对诊断测试效用函数的技术；以及评估决策稳健性的方法。提出了一些方法学解决方案，旨在捕捉通常被忽视的要素和关系，并充分认识到决策过程中归纳认知成分的存在。
