癫痫杂志

癫痫杂志

癫痫患者治疗经济评价的系统回顾

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越来越多的治疗方案和与癫痫相关的高成本促进了癫痫疾病经济评价的发展。因此,检查这些经济评价的可用性、质量并找出潜在的研究差距非常重要。除了研究抗癫痫药物(AEDs)和非药物(例如癫痫手术、生酮饮食、迷走神经刺激)治疗外,本综述还考察了所有经济评价的方法学质量。我们使用 MEDLINE,EMBASE,NHS 经济评价数据库(NHS EED),Econlit,Web of Science 和 CEA Registry 进行了文献检索。此外,还使用了 Cochrane 评价,Cochrane DARE 和 Cochrane 健康技术评价数据库。为了识别相关研究,我们设计了将预定义的临床检索策略与检索过滤器结合的模式以识别健康经济学相关的研究。以下主题都使用了特别设计的特定检索策略:① AEDs;② 认知缺陷患者;③ 老年患者;④ 癫痫手术;⑤ 生酮饮食;⑥ 迷走神经刺激;⑦ 治疗(非)惊厥性癫痫持续状态。本综述共纳入 40 篇文献,其中 29 篇(73%)为有关药物干预的文章。以“健康经济学标准共识”(Consensus health economic criteria,CHEC)评价,所有文章的平均质量评分为 81.8%,最低质量评分为 21.05%,有五项研究评分为 100%。使用综合健康经济评价报告标准(Consolidated health economic evaluation reporting standards,CHEERS),平均质量得分为 77.0%,最低为 22.7%,有四项研究评定为 100%。所有纳入的文章在方法学上存在很大的差异,这阻碍了将信息进行有意义地合并。总的来说,方法学质量是可以接受的,尽管一些研究质量明显比其他研究差。研究之间的异质性强调需要确定一个参考案例(例如应该如何进行癫痫内的经济评价),并就什么为“最佳治疗标准”达成共识。

关键词: 癫痫; 经济评价; 药物干预; 非药物干预; 研究质量

引用本文: WijnenBFM, van MastrigtGAPG, EversSMAA, 李思思 译, 高慧 慕洁 审. 癫痫患者治疗经济评价的系统回顾. 癫痫杂志, 2018, 4(6): 526-544. doi: 10.7507/2096-0247.20180085 复制

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