效用值在COPD中的应用现状及思考

Application Status and Thinking of Utility Value in COPD

成本-效用分析(CUA)综合考虑了人的生命质量和生存时间,在国内外应用日趋广泛。本研究对效用值的测量方法进行了总结,并对CUA研究中存在的问题进行思考。效用值的测量有直接测量法和间接测量法,直接测量法包括刻度法(RS)、标准博弈法(SG)、时间权衡法(TTO)、人数权衡法(PTO)和量值评估法(ME)等,间接测量法通过量表调查患者对某一健康状态的偏好程度,然后采用合适的计量经济学模型构建该量表的效用值积分体系。目前,国内COPD的CUA研究中,效用值测量的理论基础尚不完善,是否存在边际递减效应尚不明确,缺乏符合我国国情的生活质量量表,对效应值的测量方法仍需规范。

Cost and utility analysis（ CUA） takes life quality and survival time into comprehensive consideration and is widely applied both home and abroad. This research summarizes the measurement methods of utility value and reflects on the existing problems in research. Utility value can be tested by direct measurement including RS,SG,TTO,PTO and ME,and indirect measurement which is firstly an questionnaire investigation about the preferences on a certain health condition of the subjects,then a suitable econometrics model being established and finally the utility value integral system being constructed.Now,there are still some problems in the research about COPD- related CUA in China. The theoretical measurement basis is not perfect. It is vague about the existence of marginal decreasing effect. A life quality questionnaire in accordance with Chinese reality is still not researched out. The measurement methods of utility value need further standardization.