目的基于卫生服务体系角度评估贝伐珠单抗联合紫杉醇在HER-2阴性转移性乳腺癌(metastatic breast cancer,MBC)中的成本效果。方法根据E2100试验的疗效和不良事件中的数据,采用动态Markov模型模拟患者终身的直接医疗成本和质量调整生命年...目的基于卫生服务体系角度评估贝伐珠单抗联合紫杉醇在HER-2阴性转移性乳腺癌(metastatic breast cancer,MBC)中的成本效果。方法根据E2100试验的疗效和不良事件中的数据,采用动态Markov模型模拟患者终身的直接医疗成本和质量调整生命年(quality-adjusted life years,QALYs)。以增量成本-效果比(incremental cost-effectiveness ratio,ICER)为评价指标,评价贝伐珠单抗联合紫杉醇与紫杉醇治疗MBC方案的优劣,并分析结果敏感度。健康效用来自现有文献,费用从河北医科大学第四医院获取。结果贝伐珠单抗联合紫杉醇对比紫杉醇提高了0.28 QALYs,成本增加了182806元,ICER为652879元/QALY,每增加1年无进展生存期的成本为355471元。结论贝伐珠单抗联合紫杉醇能延长HER-2阴性MBC患者的生命年,提高生命质量,同时也增加医疗成本,根据WHO 3倍人均GDP的判断标准,贝伐珠单抗联合紫杉醇用于HER-2阴性MBC的一线治疗不具有成本效果优势。展开更多
With respect to the ergonomic evaluation and optimization in the mental task design of the aircraft cockpit display interface, the experimental measurement and theoretical modeling of mental workload were carried out ...With respect to the ergonomic evaluation and optimization in the mental task design of the aircraft cockpit display interface, the experimental measurement and theoretical modeling of mental workload were carried out under flight simulation task conditions using the performance evaluation, subjective evaluation and physiological measurement methods. The experimental results show that with an increased mental workload, the detection accuracy of flight operation significantly reduced and the reaction time was significantly prolonged; the standard deviation of R-R intervals（SDNN） significantly decreased, while the mean heart rate exhibited little change; the score of NASA_TLX scale significantly increased. On this basis, the indexes sensitive to mental workload were screened, and an integrated model for the discrimination and prediction of mental workload of aircraft cockpit display interface was established based on the Bayesian Fisher discrimination and classification method. The original validation and cross-validation methods were employed to test the accuracy of the results of discrimination and prediction of the integrated model, and the average prediction accuracies determined by these two methods are both higher than 85%. Meanwhile, the integrated model shows a higher accuracy in discrimination and prediction of mental workload compared with single indexes. The model proposed in this paper exhibits a satisfactory coincidence with the measured data and could accurately reflect the variation characteristics of the mental workload of aircraft cockpit display interface, thus providing a basis for the ergonomic evaluation and optimization design of the aircraft cockpit display interface in the future.展开更多
文摘目的基于卫生服务体系角度评估贝伐珠单抗联合紫杉醇在HER-2阴性转移性乳腺癌(metastatic breast cancer,MBC)中的成本效果。方法根据E2100试验的疗效和不良事件中的数据,采用动态Markov模型模拟患者终身的直接医疗成本和质量调整生命年(quality-adjusted life years,QALYs)。以增量成本-效果比(incremental cost-effectiveness ratio,ICER)为评价指标,评价贝伐珠单抗联合紫杉醇与紫杉醇治疗MBC方案的优劣,并分析结果敏感度。健康效用来自现有文献,费用从河北医科大学第四医院获取。结果贝伐珠单抗联合紫杉醇对比紫杉醇提高了0.28 QALYs,成本增加了182806元,ICER为652879元/QALY,每增加1年无进展生存期的成本为355471元。结论贝伐珠单抗联合紫杉醇能延长HER-2阴性MBC患者的生命年,提高生命质量,同时也增加医疗成本,根据WHO 3倍人均GDP的判断标准,贝伐珠单抗联合紫杉醇用于HER-2阴性MBC的一线治疗不具有成本效果优势。
基金supported by the National Basic Research Program of China (No. 2010CB734104)
文摘With respect to the ergonomic evaluation and optimization in the mental task design of the aircraft cockpit display interface, the experimental measurement and theoretical modeling of mental workload were carried out under flight simulation task conditions using the performance evaluation, subjective evaluation and physiological measurement methods. The experimental results show that with an increased mental workload, the detection accuracy of flight operation significantly reduced and the reaction time was significantly prolonged; the standard deviation of R-R intervals（SDNN） significantly decreased, while the mean heart rate exhibited little change; the score of NASA_TLX scale significantly increased. On this basis, the indexes sensitive to mental workload were screened, and an integrated model for the discrimination and prediction of mental workload of aircraft cockpit display interface was established based on the Bayesian Fisher discrimination and classification method. The original validation and cross-validation methods were employed to test the accuracy of the results of discrimination and prediction of the integrated model, and the average prediction accuracies determined by these two methods are both higher than 85%. Meanwhile, the integrated model shows a higher accuracy in discrimination and prediction of mental workload compared with single indexes. The model proposed in this paper exhibits a satisfactory coincidence with the measured data and could accurately reflect the variation characteristics of the mental workload of aircraft cockpit display interface, thus providing a basis for the ergonomic evaluation and optimization design of the aircraft cockpit display interface in the future.
