期刊
APPLIED HEALTH ECONOMICS AND HEALTH POLICY
卷 15, 期 3, 页码 333-351出版社
SPRINGER INT PUBL AG
DOI: 10.1007/s40258-017-0312-3
关键词
-
资金
- COMET Center ONCOTYROL
- Austrian Federal Ministries BMVIT/BMWFJ (via FFG)
- Tiroler Zukunftsstiftung/Standortagentur Tirol (SAT)
Background Many Western countries have long-established population-based mammography screening programs. Prior to implementing these programs, decisionanalytic modeling was widely used to inform decisions. Objective The aim of this study was to perform a systematic review of cost-effectiveness models in breast cancer screening in the general population to analyze their structural and methodological approaches. Methods A systematic literature search for health economic models was performed in the electronic databases MEDLINE (Ovid), EMBASE, CRD Databases, Cochrane Library, and EconLit in August 2011 with updates in June 2013, April 2015, and November 2016. To assess studies systematically, a standardized form was applied to extract relevant information that was then summarized in evidence tables. Results Thirty-five studies were included; 27 state-transition models were analyzed using cohort (n = 12) and individual-level simulation (n = 15). Twenty-one studies modeled the natural history of breast cancer and predicted mortality as a function of the early detection modality. The models employed different assumptions regarding ductal carcinoma in situ. Thirteen studies performed cost-utility analyses with different sources for utility values, but assumptions were often made about utility weights. Twenty-two models did not report any validation. Conclusion State-transition modeling was the most frequently applied analytic approach. Different methods in modeling the progression of ductal carcinoma in situ to invasive cancer were identified because there is currently no agreement on the biological behavior of noninvasive breast cancer. Main weaknesses were the lack of precise utility estimates and insufficient reporting of validation. Sensitivity analyses of assumptions regarding ductal carcinoma in situ and in particular adequate validation are critical to minimize the risk of biased model outcomes.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据