郑州大学学报（医学版）2017，Vol.52Issue(3)：331-334,4.DOI:10.13705/j.issn.1671-6825.2017.03.022
利用Markov模型进行胃癌高危人群胃镜监测的成本效果评价
A cost-effectiveness analysis evaluating endoscopic surveillance for high-risk population of gastric cancer using Markov model
摘要
Abstract
Aim: To explore the optimal strategies for long-term monitoring of gastric cancer by evaluating the cost-effectiveness of gastroscopy surveillance in high-risk population of gastric cancer aged 40 years using Markov model at the present economic level.Methods: Using a reference strategy of no gastroscopy intervention, simulation of 10 000 high-risk patients with gastric cancer was set, and two strategies were evaluated: annual gastroscopy surveillance and 2-yearly gastroscopy surveillance.By collecting the state transition probabilities, Markov models were built to simulate the life experience of the target population.The models projected lifetime costs, quality adjusted life year(QALY), and incremental cost-effectiveness ratio(ICER) indicating the cost-effectiveness of each strategy.Sensitivity analysis was used to quantify the influence of parameter uncertainties.Results: Annual gastroscopy surveillance could respectively extend the lives of cohort 4 835.20 QALY than no gastroscopy surveillance, and the ICER was 22 758.41 Yuan/QALY, respectively.2-yearly gastroscopy surveillance could extend 2 509.20 QALY than no gastroscopy surveillance,and the ICER was 21 974.07 Yuan/QALY.Conclusion: With the willingness-to-pay of 52 000 Yuan/QALY, the annual gastroscopy surveillance and 2-yearly gastroscopy surveillance both are cost-effective in the prevention of gastric cancer for high-risk population of gastric cancer aged 40 years.The annual gastroscopy surveillance is the optimal strategy.关键词
Markov模型/胃癌高危人群/胃镜/监测Key words
Markov model/high-risk population of gastric cancer/gastroscopy/surveillance分类
医药卫生引用本文复制引用
安书仪,薛佳殷,李苹,黄水平..利用Markov模型进行胃癌高危人群胃镜监测的成本效果评价[J].郑州大学学报（医学版）,2017,52(3):331-334,4.基金项目
江苏省科技厅社会发展项目 BE2011647 （）
