原发性肺癌卫生经济学评价模型结构研究

Construction of Economic Evaluations Models for the Treatment of Lung Cancer

[目的]卫生经济学评价模型是在肺癌相关卫生经济学评价中广泛使用的技术,全文主要阐述了已有研究中肺癌评价模型的共性和个性规律。[方法]系统检索国内外已发表的肺癌卫生经济学评价文献,比较分析不同研究中模型架构的特点,对文献中出现的决策树模型、马尔可夫模型、分区生存模型进行解析和比较。[结果]共纳入24篇国内外肺癌经济学评价文献,马尔可夫模型最常见,不同的研究在3状态的基础上发展出4、5、6甚至更多状态的模型以突出技术特点。马尔可夫决策模型适用于个体化决策治疗,以辅助决策不同治疗方案的经济性。分区生存模型架构一般为3个状态,常用于晚期或转移性癌症干预的评价。[结论]不同模型类型和结构对应于不同研究设计,应以合理反映疾病进程、符合所研究卫生技术的特点为目的来构建。

[Purpose]To describe and summarize the construction of economic evaluation models for the treatment of lung cancer.[Methods]In this study we reviewed the decision tree models,Markov models and partitioned survival models for lung cancer treatment based on systematic literature review.[Results]Twenty-four studies were included according to the inclusion and exclusion criteria.Markov model was used more widely than decision tree model and partitioned survival model.Different Markov models have been developed with 4,5,6 or more states according to the characteristics of medical technologies analyzed.Markov model is usually used to evaluate different therapeutic strategies for lung cancer in general;while partitioned survival model,with 3 states mostly,is usually used for treatment of advanced or metastatic lung cancer.[Conclusion]The structure of economic evaluation model should be constructed according to the disease pro-cess and the medical techniques used.