基于决策树模型的肺癌筛查卫生经济学评价

Health Economics Evaluation of Lung Cancer Screening Based on Decision Tree Model

目的:评价在肺癌高危人群中使用低剂量螺旋CT进行基线筛查的成本及效果。方法:通过构建肺癌筛查的决策树模型来模拟不同的筛查情景,评价LDCT筛查的投入和产出情况并进行增量成本-效果分析。结果:在假设的10万人群中,LDCT筛查队列产生的总成本为12275.31万元,与不筛查情景相比,增量成本为6397.21万元,额外获得651.84个QALYs。每获得1个QALY所需投入的成本为9.81万元。结论:使用LDCT在肺癌高危人群中进行肺癌筛查具备成本-效果,应积极推行适宜的筛查方案,并逐步扩大筛查的覆盖人群。

Objective:To evaluate the cost and effectiveness of low-dose spiral CT for baseline screening in high-risk populations of lung cancer.Methods:By constructing a decision tree model for lung cancer screening to simulate different screening scenarios,the input and output situation of LDCT screening is evaluated and the incremental cost-effectiveness ratio are evaluated.Results:In the hypothetical 100000 residents,the total cost of LDCT screening is 122.7531 million yuan.Compared with the non-screening scenario,the incremental cost is 63.9721 million yuan,and an additional 651.84 QALYs are obtained.The incremental cost-effectiveness ratio was 98138 yuan per QALY.Conclusion:LDCT screening in high-risk populations has cost-effectiveness-Appropriate screening programs should be actively promoted,and the coverage of screening should be gradually expanded.