中国药物经济学2025，Vol.20Issue(6)：38-44,55,8.DOI:10.12010/j.issn.1673-5846.2025.06.006
基于冠状动脉CT血管造影人工智能辅助诊断冠状动脉粥样硬化性心脏病的经济学评价
Economic Evaluation of Artificial Intelligence-assisted Diagnosis of Coronary Atherosclerotic Heart Disease based on Coronary CT Angiography
摘要
Abstract
Objective To evaluate the economy of applying the intelligent auxiliary diagnosis system of coronary CT angiography(CCTA)in the diagnosis of coronary atherosclerotic heart disease(CAD)from the perspective of the health system.Methods Taking the diagnostic accuracy as the effect value,the cost-effectiveness of CCTA-AI and CCTA-manual diagnosis was compared.The decision tree model was constructed through Treeage Pro 2011 software.Taking the quality-adjusted life years(QALYs)as the utility index,the cost input and benefit of CAD patients using the CCTA artificial intelligence-assisted diagnosis technology for one year were simulated to compare the cost-utility of CCTA-AI and CCTA-manual diagnosis.And univariate and probabilistic sensitivity analyses were conducted to verify the stability of the model results.Results based on the cost-effectiveness analysis of diagnostic accuracy,the cost of the AI group was 1 074 900 yuan with an effect of 855.05,and the cost of the manual group was 1 266 610 yuan,with an effect of 815.068 5 for the high-year-old physician group,and 793.4 for the low-year-old physician group,which gave an absolute advantage to the AI group.The results of the decision-tree modeling analysis showed that,compared with the high-year-old physician group,the ICUR value of AI group was 2 969 386.318 32 yuan/QALY,and compared to the low seniority physician group,the ICUR value of AI group was 3 682 121.485 41 yuan/QALY,both of which were greater than the threshold value(268 074 yuan),indicating that for every unit of increase in the value of utility of the AI group,its cost was unacceptable at this threshold value.The results of both the one-way sensitivity analysis and the probabilistic sensitivity analysis showed that the results of the underlying analysis were robust.Conclusion When diagnostic accuracy is used as the effect indicator for CEA,AI-assisted diagnosis has an absolute advantage over manual diagnosis.However,when diagnosis is placed in the short-term diagnosis and treatment process of CAD and QALYs is used as the utility indicator to examine the cost-effectiveness from CAD diagnosis to treatment within one year,the conclusion drawn is that AI-assisted diagnosis is uneconomical.关键词
冠状动脉粥样硬化性心脏病/人工智能辅助诊断/冠状动脉CT血管造影Key words
Coronary atherosclerotic heart disease/Artificial intelligence-assisted diagnosis/Coronary CT angiography分类
医药卫生引用本文复制引用
赵佳钰,肖月,史黎炜,刘永军..基于冠状动脉CT血管造影人工智能辅助诊断冠状动脉粥样硬化性心脏病的经济学评价[J].中国药物经济学,2025,20(6):38-44,55,8.基金项目
科技创新2030—"新一代人工智能"重大项目(2020AAA0105002) （2020AAA0105002）
