Value in health regional issues最新文献_第3页

Psychometric Performance of EQ-HWB and EQ-HWB-9 Self-Complete and Interviewer-Administered Versions in Literate, Low-Literacy, and Patient Populations in Indonesia EQ-HWB和EQ-HWB-9自填版本和访谈者管理版本在印尼识字、低识字和患者人群中的心理测量表现。

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-05-01 Epub Date: 2025-11-18 DOI: 10.1016/j.vhri.2025.101543

Fredrick Dermawan Purba MPsi, PhD, Psikolog , Grace Helena Firmansyah Putri MPsi, Psikolog , Putu Getsha Pradnyan Rarasati Mudita SPsi, MPsi

Objectives

This study aimed to evaluate the psychometric performance, including test-retest reliability, ceiling/floor effects, and construct validity of the interviewer-administered (IA) and self-completion (SC) versions of EQ Health and Well-being instrument (EQ-HWB) and EQ-HWB-9.

Methods

A longitudinal survey in Bandung, Indonesia, recruited 300 respondents using stratified quota sampling, comprising 200 literate individuals, 50 with low literacy or illiteracy, and 50 patients. Respondents completed EQ-HWB, EQ-5D-5L, and Warwick-Edinburgh Mental Well-being Scale using either IA or SC modes. Psychometric analyses included ceiling/floor effects, convergent and known-group validity, and test-retest reliability (Gwet’s AC2, intraclass correlation coefficients).

Results

The final sample (mean age 39.22 ± 15.81, 62.67% female) demonstrated ceiling effects on EQ-HWB items ranging from 24.0% (“Exhaustion”) to 86.33% (“Hearing”), with 5 items exceeding the 70% threshold. In contrast, EQ-HWB-9 showed lower ceiling effects, with only 1 item (“Getting around inside and outside”) reaching the ceiling criterion (71.67%). Strong IA-SC agreement was observed (eg, AC2 = 0.95 for “Getting around inside and outside”). In the illiterate subgroup, item-level agreement remained strong, and instrument-level reliability was acceptable, supporting the feasibility of interviewer administration in low-literacy populations. Convergent validity was established with EQ-5D-5L and Warwick-Edinburgh Mental Well-being Scale. Known-group comparisons based on EQ-VAS (<80 vs ≥80) and patient status showed significant discrimination.

Conclusions

To our knowledge, this is the first study to validate the experimental IA versions of EQ-HWB and EQ-HWB-9 in Indonesia. The findings support their robust psychometric properties and feasibility for use in low-literacy and patient populations.

目的：本研究旨在评估情商健康与幸福量表（EQ- hwb）和EQ- hwb -9 （EQ- hwb -9）的访谈者自编版本（IA）和自我完成版本（SC）的心理测量性能，包括重测信度、上限/下限效应和结构效度。方法：在印度尼西亚万隆进行纵向调查，采用分层配额抽样方法招募300名受访者，其中包括200名识字的人，50名低识字或文盲，以及50名患者。受访者使用IA或SC模式完成EQ-HWB、EQ-5D-5L和Warwick-Edinburgh心理健康量表。心理测量分析包括天花板/地板效应、收敛效度和已知组效度以及重测信度（Gwet的AC2，类内相关系数）。结果：最终样本（平均年龄39.22±15.81岁，女性62.67%）在EQ-HWB项目上表现出天花板效应，范围从24.0%（“疲惫”）到86.33%（“听力”），有5个项目超过70%的阈值。EQ-HWB-9的上限效应较低，只有1项（“室内外活动”）达到上限标准（71.67%）。观察到强IA-SC一致性（例如，“inside and outside”的AC2 = 0.95）。在文盲亚组中，项目水平的一致性仍然很强，工具水平的可靠性是可以接受的，支持在低识字率人群中采访者管理的可行性。采用EQ-5D-5L和Warwick-Edinburgh心理健康量表建立收敛效度。结论：据我们所知，这是印度尼西亚首次验证EQ-HWB和EQ-HWB-9实验IA版本的研究。这些发现支持了它们强大的心理测量特性和在低文化水平和患者群体中使用的可行性。

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引用次数: 0

Incremental Direct Cost of Chronic Obstructive Pulmonary Disease in Colombia Using Doubly Robust Methods on Administrative Data 哥伦比亚慢性阻塞性肺疾病的增量直接成本管理数据双稳健方法

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-05-01 Epub Date: 2025-10-23 DOI: 10.1016/j.vhri.2025.101513

Carlos F. Valencia PhD, Juan F. Martínez MSc

Objectives

To estimate incremental healthcare costs associated with chronic obstructive pulmonary disease (COPD) using administrative healthcare data in Colombia.

Methods

We conducted a retrospective cohort analysis using administrative health databases from Colombia’s population covered by the contributory health insurance scheme. Patients with COPD were identified using a specific operative definition, and the control group was randomly selected from the remaining individuals. To estimate the incremental cost of COPD, we applied a causal approach using a doubly robust model, integrating propensity scores and outcome regression models. This ensured accurate estimation by addressing potential confounding, being robust for misspecification both in the propensity score and in the mean outcome. Confidence intervals were obtained using bootstrapping. In addition, we analyzed the incremental effect of common COPD complications, such as cardiovascular diseases and pulmonary infections.

Results

Our group of patients with COPD was comprised 251 060 people, whereas our control group comprised 967 081 people. The estimated incremental cost of a person with COPD was US dollars $1349. The incremental cost of a person with COPD and some type of complication ranged from $1405 to $2935. The most expensive complication was lung cancer, and the least expensive complication was any type of muscular weakness.

Conclusions

The incremental costs of COPD in Colombia align with the average values typically reported for middle-income countries. However, these estimates fall on the lower end of global cost estimations. There was a greater incremental cost found for patients with complications such as lung cancer, cardiovascular diseases, and pulmonary infections.

目的利用哥伦比亚的行政医疗数据估计与慢性阻塞性肺疾病（COPD）相关的增量医疗费用。方法我们利用哥伦比亚的行政卫生数据库对参加缴费式健康保险计划的人口进行了回顾性队列分析。使用特定的手术定义来确定COPD患者，并从其余个体中随机选择对照组。为了估计COPD的增量成本，我们采用了双重稳健模型的因果方法，整合了倾向评分和结果回归模型。这确保了准确的估计，通过解决潜在的混淆，在倾向得分和平均结果中对错误规范都是稳健的。采用自举法获得置信区间。此外，我们还分析了常见COPD并发症（如心血管疾病和肺部感染）的增量效应。结果本组COPD患者共251 060人，对照组967 081人。慢性阻塞性肺病患者的估计增量成本为1349美元。患有慢性阻塞性肺病和某些类型并发症的患者的增量成本从1405美元到2935美元不等。最昂贵的并发症是肺癌，最便宜的并发症是任何类型的肌肉无力。结论：哥伦比亚慢性阻塞性肺病的增量成本与中等收入国家通常报告的平均值一致。然而，这些估计属于全球成本估计的低端。对于肺癌、心血管疾病和肺部感染等并发症患者，增加的费用更大。

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引用次数: 0

Assessing the Impact of a Social Program Using EQ-HWB-9 and EQ-5D-5L: The Dara Project 使用EQ-HWB-9和EQ-5D-5L评估社会项目的影响：数据项目

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-05-01 Epub Date: 2025-11-07 DOI: 10.1016/j.vhri.2025.101524

Marisa Santos PhD , Marcelo G. Correia MSc , Vanessa R. von Doellinger PhD , Sylvia Lordello MD , Andrea L. Monteiro PhD

Objectives

The EQ Health and Well-being (EQ-HWB) is an instrument designed to measure quality of life across health and social care. This study aimed to evaluate the responsiveness of the short version (EQ-HWB-9) in a Brazilian vulnerable population.

Methods

A pre- and postcohort design was used to evaluate the effects of a 6-month multidimensional social intervention. Data were collected at baseline and follow-up from 98 participants using an electronic questionnaire via REDCap, including official electronic versions of EQ-HWB-9, EQ-5D-5L, and the Perceived Change Scale. A single trained interviewer conducted all interviews. Known-groups comparisons and responsiveness were examined using descriptive statistics, paired tests (Wilcoxon and t tests), and subgroup analyses. Health index values were derived using validated scoring algorithms, including the UK value set for EQ-HWB-9 and the Brazilian EQ-5D-3L crosswalk for EQ-5D-5L.

Results

EQ-HWB-9 distinguished between groups with different health statuses and perceived changes. Significant improvements were observed from baseline to follow-up for EQ-HWB-9 and EQ-5D-5L (P < .001); Visual Analog Scale (VAS) scores had increased but were not statistically significant (P = .152).

Conclusions

In this pre-post cohort, EQ-HWB-9 detected 6-month improvements across multiple domains during a multidimensional program in Brazil, suggesting utility for outcome monitoring while not permitting causal inference.

EQ健康与幸福（EQ- hwb）是一种旨在衡量健康和社会关怀生活质量的工具。本研究旨在评估巴西易感人群对EQ-HWB-9短版本的反应性。方法采用队列前后设计评价6个月多维社会干预的效果。在基线和随访时，使用REDCap的电子问卷收集了98名参与者的数据，包括EQ-HWB-9、EQ-5D-5L和感知变化量表的官方电子版本。一名训练有素的采访者进行了所有的采访。使用描述性统计、配对检验（Wilcoxon和t检验）和亚组分析检验已知组比较和反应性。使用经过验证的评分算法得出健康指数值，包括英国的EQ-HWB-9值和巴西的EQ-5D-3L人行横道的EQ-5D-5L值。结果tseq - hwb -9在不同健康状况和感知变化组间具有显著性。从基线到随访，EQ-HWB-9和EQ-5D-5L有显著改善（P < 0.001）；视觉模拟量表（VAS）评分有升高，但无统计学意义（P = 0.152）。在这个前后队列中，EQ-HWB-9在巴西的多维项目中检测到6个月来多个领域的改善，这表明结果监测的实用性，但不允许因果推理。

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引用次数: 0

Custo-Efetividade da Teriparatida em Homens com Osteoporose Grave no Brasil 特利帕肽治疗巴西男性严重骨质疏松症的成本-效果

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-05-01 Epub Date: 2025-12-12 DOI: 10.1016/j.vhri.2025.101553

Cid Manso de Mello Vianna PhD , Gabriela Bittencourt Gonzalez Mosegui PhD , Tácio de Mendonça Lima PhD , Tayna Felicíssimo Gomes de Souza Bandeira MS , Marcus Paulo da Silva Rodrigues PhD

Objectives

To calculate the cost-effectiveness ratio and the budget impact of teriparatide use in men with severe osteoporosis and history of fractures in Brazil.

Methods

Three hypothetical cohorts of men with severe osteoporosis and history of fracture, with initial ages of 50, 60, and 70 years, were simulated using a Markov Model to calculate the cost-effectiveness ratio between teriparatide and alendronate and risedronate, from the perspective of the Unified Health System (SUS). The time horizon was 10 years, with cycles of 1 year. Effectiveness outcomes were measured in quality-adjusted life-years (QALY). Deterministic and probabilistic sensitivity analyses were performed.

Results

Teriparatide compared with alendronate and risedronate has an incremental cost-effectiveness ratio of 77,002/79,808 R$/QALY, 305,435/439,636 R$/QALY, and 327,869/460,333 R$/QALY for 50, 60, and 70 years, respectively. The deterministic and probabilistic evaluations did not produce results that altered the previous conclusion and, in all situations, the teriparatide was not cost-effective for a threshold of R$ 40,000.00/QALY. The analysis of the budget impact estimated that the use of teriparatide for a market share of 60% in 5 years would have an additional cost of approximately R$ 187 million.

Conclusions

In the analyzed scenarios, the use of bisphosphonates produces resource savings in relation to teriparatide in the treatment of men. Teriparatide was not cost-effective in any situation.

目的计算特立帕肽在巴西重度骨质疏松和有骨折史的男性患者中的成本-效果比和预算影响。方法采用马尔可夫模型，从统一卫生系统（SUS）的角度计算特立帕肽与阿仑膦酸钠和利塞膦酸钠的成本-效果比，对初始年龄分别为50岁、60岁和70岁、有严重骨质疏松和骨折史的男性进行模拟。时间范围为10年，周期为1年。有效性结果以质量调整生命年（QALY）衡量。进行了确定性和概率敏感性分析。结果与阿仑膦酸钠和利塞膦酸钠相比，50年、60年和70年的增量成本-效果比分别为77,002/79,808 R$/QALY、305,435/439,636 R$/QALY和327,869/460,333 R$/QALY。确定性和概率评估没有产生改变先前结论的结果，在所有情况下，特立帕肽在40,000.00雷亚尔/QALY的阈值下都不具有成本效益。对预算影响的分析估计，在5年内使用特立帕肽以获得60%的市场份额将产生约1.87亿雷亚尔的额外费用。结论在分析的情况下，使用双膦酸盐在男性治疗中比使用特立帕肽节省了资源。特立帕肽在任何情况下都不具有成本效益。

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引用次数: 0

Long-Term Changes in Health-Related Quality of Life and Economic Burden After a SARS-CoV-2 Infection: Analysis of the Long COVID Prospective Cohort Study in Nairobi SARS-CoV-2感染后健康相关生活质量和经济负担的长期变化：内罗毕长期COVID前瞻性队列研究分析

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-05-01 Epub Date: 2025-11-18 DOI: 10.1016/j.vhri.2025.101545

Ângela Jornada Ben MD, PhD , Isaac Kisiangani MSc , Idah Kinya MSc , Elke Wynberg PhD , Menno D. de Jong PhD , Constance Schultsz PhD , Gershim Asiki PhD , Anna Vassall PhD

Objectives

To characterize long-term changes in health-related quality of life (HRQoL) and factors associated with catastrophic expenditures and catastrophic costs after a SARS-CoV-2 infection.

Methods

Data from 291 participants of the Long COVID Prospective Cohort Study in Nairobi were analyzed. Participants were enrolled between 2022 and 2023 and followed up for 12 months. Possible factors and outcomes (HRQoL, catastrophic expenditures, and catastrophic costs) were measured every 3 months. Changes in outcomes over time were assessed using generalized estimating equations.

Results

HRQoL was significantly reduced by 11.4% (95% CI −16.3% to −6.5%), 8.6% (95% CI −12.5% to −4.6%), 6.1% (95% CI −10.5% to −1.8%), and 4.1% (95% CI −7.9% to −0.3%) at 6, 9, 12, and 15 months after a positive polymerase chain reaction test, respectively, compared with the period before COVID-19. HRQoL was significantly reduced by 3.3% (95% CI −6.2% to −0.5%), and 10.9% (95% CI −16.5% to −5.3%), respectively, in participants with any COVID-19-related symptoms or fatigue. Older age (odds ratio [OR] 5.83, 95% CI 2.11 to 16.15), no COVID-19 vaccination (OR 5.83, 95% CI 2.11 to 16.15), any COVID-19-related symptoms (OR 2.22, 95% CI 1.15 to 4.28), and pay cut or reduced income due to COVID-19-related symptoms (OR 17.36, 95% CI 2.28 to 132.07) were associated with high odds of experiencing catastrophic expenditures. Severe/critical SARS-CoV-2 infection (OR 4.77, 95% CI 1.72 to 13.25) and fatigue (OR 2.27, 95% CI 1.03 to 4.96) significantly increased the odds of experiencing catastrophic costs, whereas better HRQoL (OR 0.12, 95% CI 0.02 to 0.57) and social support (OR 0.30, 95% CI 0.09 to 0.93) decreased the odds.

Conclusions

HRQoL remains reduced up to 15 months after a SARS-CoV-2 infection compared with pre-COVID-19 levels, with participants in better health and socioeconomic status less likely to experience catastrophic expenditures and catastrophic costs.

目的：描述SARS-CoV-2感染后健康相关生活质量（HRQoL）的长期变化以及与灾难性支出和灾难性成本相关的因素。方法：对来自内罗毕的291名长期COVID前瞻性队列研究参与者的数据进行分析。参与者在2022年至2023年间注册，并随访了12个月。每3个月测量一次可能的因素和结果（HRQoL、灾难性支出和灾难性成本）。使用广义估计方程评估结果随时间的变化。结果：与COVID-19前相比，聚合酶链反应试验阳性后6、9、12和15个月，HRQoL分别显著降低11.4% （95% CI -16.3%至-6.5%）、8.6% （95% CI -12.5%至-4.6%）、6.1% （95% CI -10.5%至-1.8%）和4.1% （95% CI -7.9%至-0.3%）。在有任何与covid -19相关症状或疲劳的参与者中，HRQoL分别显着降低3.3% （95% CI -6.2%至-0.5%）和10.9% （95% CI -16.5%至-5.3%）。年龄较大（比值比[OR] 5.83, 95% CI 2.11至16.15）、未接种COVID-19疫苗（比值比[OR] 5.83, 95% CI 2.11至16.15）、任何与COVID-19相关的症状（比值比[OR] 2.22, 95% CI 1.15至4.28）以及因COVID-19相关症状导致的减薪或收入减少（比值比[OR] 17.36, 95% CI 2.28至132.07）与发生灾难性支出的高几率相关。严重/危重SARS-CoV-2感染（OR 4.77, 95% CI 1.72至13.25）和疲劳（OR 2.27, 95% CI 1.03至4.96）显著增加了经历灾难性成本的几率，而较好的HRQoL （OR 0.12, 95% CI 0.02至0.57）和社会支持（OR 0.30, 95% CI 0.09至0.93）降低了这一几率。结论：与covid -19前的水平相比，SARS-CoV-2感染后长达15个月的HRQoL仍然降低，健康状况和社会经济地位较好的参与者不太可能经历灾难性支出和灾难性成本。

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引用次数: 0

Cost-Utility Analysis of Add-On Vericiguat to Standard Treatment in Thai Patients With Heart Failure and Reduced Ejection Fraction 泰国心力衰竭和射血分数降低患者标准治疗中附加Vericiguat的成本-效用分析

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-05-01 Epub Date: 2025-11-06 DOI: 10.1016/j.vhri.2025.101514

Tanawan Kongmalai MD, PhD , Kanchalaporn Jirataiporn RN , Rungroj Krittayaphong MD

Objectives

This study aimed to evaluate the cost-utility of adding vericiguat to standard-of-care therapy for patients with heart failure with reduced ejection fraction (HFrEF) and worsening heart failure (HF) events in the context of Thailand’s healthcare system.

Methods

A Markov model using Microsoft Excel was conducted to simulate the lifetime economic outcomes of adding vericiguat to standard-of-care therapy (SoCT) compared with SoCT alone for Thai patients with HFrEF. Model parameters were derived from the VICTORIA trial and supplemented with local data on healthcare costs and utilities. Sensitivity, subgroup, and threshold analyses were also performed.

Results

Adding vericiguat to SoCT increased total life-years (LYs) from 5.80 to 5.98 and quality-adjusted life-years (QALYs) from 2.74 to 2.85. However, it also increased total lifetime costs by 114 740 THB ($3114) per patient compared with SoCT alone, resulting in an incremental cost-effectiveness ratio of 1 063 375 THB ($28 857) per QALY gained. Subgroup analysis based on NT-proBNP levels demonstrated that vericiguat had a more favorable incremental cost-effectiveness ratio of 557 427 THB ($15 127) per QALY gained in patients with NT-proBNP ≤ 4000 pg/mL. Considering the current willingness-to-pay threshold of 160 000 THB ($4342) per QALY gained in Thailand, vericiguat did not meet the cost-effectiveness criteria.

Conclusions

Despite its clinical benefits in reducing HF hospitalizations and cardiovascular mortality, vericiguat as an adjunct to SoCT for patients with HFrEF in Thailand exceeds the accepted cost-effectiveness threshold of 4342 USD/QALY gained. A price reduction of 90.2% would be necessary to achieve the current Thai willingness-to-pay threshold.

目的：本研究旨在评估在泰国医疗保健系统的背景下，将vericiguat添加到心力衰竭伴射血分数降低（HFrEF）和心力衰竭（HF）事件恶化的患者的标准护理治疗中的成本-效用。方法采用Microsoft Excel建立马尔可夫模型，模拟泰国HFrEF患者在标准治疗（SoCT）基础上加入验证疗法（vericiguat）与单独使用SoCT的终身经济结果。模型参数来源于维多利亚试验，并辅以当地医疗成本和公用事业数据。还进行了敏感性、亚组和阈值分析。结果在SoCT中加入vericiguiguy，总生命年（LYs）由5.80提高到5.98，质量调整生命年（QALYs）由2.74提高到2.85。然而，与单独使用SoCT相比，它也使每位患者的总生命周期成本增加了114 740泰铢（3114美元），导致每个QALY获得的增量成本-效果比为1 063 375泰铢（28 857美元）。基于NT-proBNP水平的亚组分析表明，对于NT-proBNP≤4000 pg/mL的患者，vericiguat的增量成本-效果比为557 427 THB（15 127美元）/ QALY更有利。考虑到目前在泰国获得的每个QALY的支付意愿门槛为16万泰铢（4342美元），vericiguat不符合成本效益标准。结论：尽管vericiguat在降低HF住院率和心血管死亡率方面具有临床益处，但在泰国，vericiguat作为HFrEF患者SoCT的辅助治疗超过了公认的成本-效果阈值4342美元/QALY。要达到目前泰国人的支付意愿门槛，价格降低90.2%是必要的。

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引用次数: 0

Cost-Effectiveness of Resmetirom for Metabolic Dysfunction-Associated Steatohepatitis in Brazil 雷舒美治疗巴西代谢功能障碍相关脂肪性肝炎的成本-效果

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-05-01 Epub Date: 2025-11-20 DOI: 10.1016/j.vhri.2025.101526

Windson Hebert Araújo Soares BPharm , Guilherme Grossi Lopes Cançado MD, MSc, PhD , André Soares Motta-Santos PhD

Objectives

To assess the cost-effectiveness of resmetirom for the treatment of metabolic dysfunction-associated steatohepatitis in Brazil.

Methods

A Markov model was developed using TreeAge Pro® 2009 from the perspective of the Brazilian public healthcare system. The model used a 20-year time horizon with annual cycles. Seven health states were included: absence of fibrosis (F0), mild to advanced fibrosis (F1, F2, and F3), cirrhosis (F4), liver transplantation, and mortality. Costs were reported in Brazilian reais (BRL) and purchasing power parity US dollars (PPP-USD), and outcomes were measured in quality-adjusted life-years (QALYs). Both deterministic and probabilistic sensitivity analyses were performed. Incremental cost-effectiveness ratios (ICERs) were compared with multiple willingness-to-pay thresholds to determine cost-effectiveness.

Results

Resmetirom demonstrated an average incremental cost of 121 762 PPP-USD and an incremental gain of 1.05 QALYs compared with placebo. The mean ICER was approximately 40 017 PPP-USD/QALY, with a symmetric distribution and moderate variability (30 869-50 234 PPP-USD/QALY). The ICER scatterplot showed a predominance in the northeast quadrant, with no instances of dominance. The model was consistent across variations in input parameters.

Conclusions

Resmetirom was more effective than placebo but incurred higher costs. From the healthcare system perspective, it was not considered cost-effective under Brazil’s conventional willingness-to-pay thresholds (1 to 3 times gross domestic product per capita per QALY) or thresholds based on opportunity cost. These findings underscore the need for caution in coverage and reimbursement decisions.

目的评估雷司替罗治疗巴西代谢功能障碍相关脂肪性肝炎的成本-效果。方法采用TreeAge Pro®2009软件从巴西公共卫生系统的角度建立马尔可夫模型。该模型使用了20年的时间范围，并以年为周期。包括7种健康状态：无纤维化（F0）、轻度至晚期纤维化（F1、F2和F3）、肝硬化（F4）、肝移植和死亡率。成本以巴西雷亚尔（BRL）和购买力平价美元（PPP-USD）报告，结果以质量调整生命年（QALYs）衡量。进行了确定性和概率敏感性分析。将增量成本-效果比（ICERs）与多个支付意愿阈值进行比较，以确定成本-效果。结果与安慰剂相比，resmetirom的平均增量成本为121 762 PPP-USD，增量收益为1.05 qaly。平均ICER约为40 017 PPP-USD/QALY，具有对称分布和中等变异性（30 869-50 234 PPP-USD/QALY）。ICER散点图显示东北象限为优势，无优势实例。该模型在输入参数的变化中是一致的。结论瑞司替龙的治疗效果优于安慰剂，但成本较高。从医疗保健系统的角度来看，在巴西传统的支付意愿阈值（每QALY人均国内生产总值的1至3倍）或基于机会成本的阈值下，它被认为不具有成本效益。这些发现强调了在覆盖范围和报销决定方面需要谨慎。

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引用次数: 0

Comparative Assessment of Short Form 6-Dimension Health State Preferences Among Lebanese Population Pre- and Post-COVID-19 Pandemic 2019冠状病毒病大流行前后黎巴嫩人群短格式6维健康状态偏好的比较评估

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-05-01 Epub Date: 2025-11-10 DOI: 10.1016/j.vhri.2025.101540

Samer A. Kharroubi PhD , Donna Rowen PhD , Rouba Ballout MSc

Objectives

Lebanon’s socio-economic situation has deteriorated significantly in recent years, a decline further exacerbated by the COVID-19 pandemic. This multifaceted crisis may have shaped how individuals perceive and value different health states. The primary objective of this study was to assess and compare health state preferences of the general Lebanese population before and after the COVID-19 pandemic using the Short Form 6-dimension (SF-6D) measure. A secondary objective was to identify key predictors of these preferences, including sociodemographic, health, and lifestyle factors.

Methods

A cross-sectional study was conducted before and after the pandemic. A total of 249 SF-6D-defined health states were valued by 577 participants from the general population using standard gamble. Independent-samples t tests and chi-square analyses examined differences in characteristics, whereas linear regression models identified predictors of SF-6D utility scores.

Results

Data from 553 eligible respondents provided 3308 valuations: 1813 from 303 respondents pre-COVID (July-October 2019) and 1495 from 250 respondents post-COVID (February-July 2022). Results showed a significant shift in health state preferences post-COVID, with higher mean utility scores (pre-COVID: 0.646 ± 0.284; post-COVID: 0.719 ± 0.258). Multiple regression analysis, adjusting for sociodemographic and health state dimensions, identified time (pre/post-COVID) (B = 0.070; P < .001), number of children ≤ 14 (B = −0.017; P < .001), educational (B = 0.006; P = .039), smoking (B = −0.006; P < .001), and health conditions such as asthma (B = 0.028; P = .024) and liver problems (B = 0.055; P = .006) as significant predictors.

Conclusions

This study highlights important shifts in health state preferences in Lebanon post-COVID. The influence of family burden and lifestyle factors on valuations has implications for public health policy, particularly when relying on prepandemic data.

目标：近年来，黎巴嫩的社会经济状况严重恶化，COVID-19大流行进一步加剧了这种恶化。这种多方面的危机可能影响了个人对不同健康状态的看法和价值。本研究的主要目的是使用短格式6维（SF-6D）测量方法评估和比较黎巴嫩普通人群在COVID-19大流行前后的健康状况偏好。第二个目标是确定这些偏好的关键预测因素，包括社会人口、健康和生活方式因素。方法：在大流行前后进行横断面研究。来自普通人群的577名参与者使用标准赌博对总共249种sf - 6d定义的健康状态进行了评估。独立样本t检验和卡方分析检验了特征差异，而线性回归模型确定了SF-6D效用得分的预测因子。结果：来自553名合格受访者的数据提供了3308个估值：来自covid前（2019年7月至10月）的303名受访者提供了1813个估值，来自covid后（2022年2月至7月）的250名受访者提供了1495个估值。结果显示，冠状病毒感染后，健康状态偏好发生了显著变化，平均效用得分更高（冠前：0.646±0.284；冠后：0.719±0.258）。多元回归分析，调整社会人口统计学和健康状况维度，确定时间（covid前/后）（B = 0.070, P < 0.001）、儿童人数≤14 （B = -0.017, P < 0.001）、教育程度（B = 0.006, P = 0.039）、吸烟（B = -0.006, P < 0.001）和健康状况(如哮喘（B = 0.028, P = 0.024）和肝脏问题（B = 0.055, P = 0.006）为显著预测因素。结论：本研究突出了黎巴嫩疫情后健康状况偏好的重要变化。家庭负担和生活方式因素对估值的影响对公共卫生政策有影响，特别是在依赖大流行前数据时。

{"title":"Comparative Assessment of Short Form 6-Dimension Health State Preferences Among Lebanese Population Pre- and Post-COVID-19 Pandemic","authors":"Samer A. Kharroubi PhD , Donna Rowen PhD , Rouba Ballout MSc","doi":"10.1016/j.vhri.2025.101540","DOIUrl":"10.1016/j.vhri.2025.101540","url":null,"abstract":"<div><h3>Objectives</h3><div>Lebanon’s socio-economic situation has deteriorated significantly in recent years, a decline further exacerbated by the COVID-19 pandemic. This multifaceted crisis may have shaped how individuals perceive and value different health states. The primary objective of this study was to assess and compare health state preferences of the general Lebanese population before and after the COVID-19 pandemic using the Short Form 6-dimension (SF-6D) measure. A secondary objective was to identify key predictors of these preferences, including sociodemographic, health, and lifestyle factors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted before and after the pandemic. A total of 249 SF-6D-defined health states were valued by 577 participants from the general population using standard gamble. Independent-samples <em>t</em> tests and chi-square analyses examined differences in characteristics, whereas linear regression models identified predictors of SF-6D utility scores.</div></div><div><h3>Results</h3><div>Data from 553 eligible respondents provided 3308 valuations: 1813 from 303 respondents pre-COVID (July-October 2019) and 1495 from 250 respondents post-COVID (February-July 2022). Results showed a significant shift in health state preferences post-COVID, with higher mean utility scores (pre-COVID: 0.646 ± 0.284; post-COVID: 0.719 ± 0.258). Multiple regression analysis, adjusting for sociodemographic and health state dimensions, identified time (pre/post-COVID) (B = 0.070; <em>P</em> < .001), number of children ≤ 14 (B = −0.017; <em>P</em> < .001), educational (B = 0.006; <em>P</em> = .039), smoking (B = −0.006; <em>P</em> < .001), and health conditions such as asthma (B = 0.028; <em>P</em> = .024) and liver problems (B = 0.055; <em>P</em> = .006) as significant predictors.</div></div><div><h3>Conclusions</h3><div>This study highlights important shifts in health state preferences in Lebanon post-COVID. The influence of family burden and lifestyle factors on valuations has implications for public health policy, particularly when relying on prepandemic data.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"53 ","pages":"Article 101540"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating the Performance of Claude 3.7 Sonnet in Data Extraction Automation for Systematic Literature Reviews 评价Claude 3.7十四行诗在数据提取自动化中的性能，用于系统文献综述。

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-05-01 Epub Date: 2025-11-11 DOI: 10.1016/j.vhri.2025.101539

Ellen Kasireddy MHSc, Cuthbert Chow MSc, Jun Collet MSc, Mir-Masoud Pourrahmat MSc, Mir Sohail Fazeli PhD

Objectives

To evaluate the performance of Claude 3.7 Sonnet in automating data extraction for systematic literature reviews (SLRs).

Methods

An artificial intelligence (AI) extraction model based on the Claude 3.7 Sonnet large language model was developed through a structured process, including targeted training using a master data list and selected full-text articles. The master data list enhanced the model’s contextual knowledge, guiding data extraction. Seven full-text articles from 4 oncology-focused treatment efficacy and safety SLRs were used for early testing and iterative refinement through error analysis. Model performance was then evaluated using 20 full-text articles, drawn from the same SLRs but not used for model development, and benchmarked against human extractions. Evaluation metrics included precision, recall, and F1 score. Extraction time was also compared across 3 different approaches: AI model-only, hybrid (AI model with human verification), and traditional human extraction.

Results

The AI model extracted 117 889 data points across 106 variables, achieving an overall precision of 98.2%, recall of 96.6%, and F1-score of 97.4%. Extraction performance was highest for Study Characteristics (precision: 97.7%, recall: 98.7%) and Participant Characteristics (precision: 97.3%, recall: 98.7%). Outcome data showed 96.4% recall and 98.7% precision. Intervention Characteristics achieved 97.5% precision and 94.6% recall. Extraction using the AI model alone averaged 4.5 minutes per article, compared with 64.5 minutes with the hybrid approach and approximately 240 minutes with traditional human extraction.

Conclusions

The Claude 3.7 Sonnet-based model demonstrated strong performance, supporting efficient and reliable AI-driven data extraction in oncology SLRs, with potential for broader applicability.

目的：评价Claude 3.7 Sonnet在系统文献综述（SLRs）中自动数据提取的性能。方法：基于Claude 3.7 Sonnet大语言模型，通过结构化的过程，包括使用主数据列表和选择的全文文章进行有针对性的训练，开发人工智能（AI）提取模型。主数据列表增强了模型的上下文知识，指导数据提取。来自4个肿瘤治疗疗效和安全性slr的7篇全文文章被用于早期测试和通过误差分析进行迭代改进。然后使用20篇全文文章对模型性能进行评估，这些文章取自相同的单反，但不用于模型开发，并对人类提取进行基准测试。评估指标包括准确率、召回率和F1分数。还比较了三种不同方法的提取时间：仅人工智能模型、混合（人工验证的人工智能模型）和传统的人工提取。结果：人工智能模型在106个变量中提取了117889个数据点，总体精度为98.2%，召回率为96.6%，f1得分为97.4%。研究特征（精密度：97.7%，召回率：98.7%）和参与者特征（精密度：97.3%，召回率：98.7%）的提取性能最高。结果数据显示召回率为96.4%，准确率为98.7%。干预特征的准确率为97.5%，召回率为94.6%。单独使用人工智能模型的提取平均每篇文章4.5分钟，而混合方法的提取时间为64.5分钟，传统的人工提取时间约为240分钟。结论：基于Claude 3.7十四行诗的模型表现出强大的性能，支持高效可靠的ai驱动的肿瘤单反数据提取，具有更广泛的适用性。

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引用次数: 0

Improving Access to Nuclear Medicine in Island Regions: A Cost-Minimization Analysis of Radiopharmaceutical Supply Strategies 改善岛屿地区获得核医学的机会：放射性药物供应战略的成本最小化分析

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES

Value in health regional issues

Pub Date : 2026-05-01 Epub Date: 2025-10-24 DOI: 10.1016/j.vhri.2025.101510

Christos Melidis MSc , Sandrine Noblet PhD , Samuel Burg MD , Panagiotis Bamidis PhD , Ioannis Iakovou MD, PhD

Objectives

Access to positron emission tomography (PET) services is limited in many island regions because of dependence on externally produced radiopharmaceuticals and associated logistical constraints. This study provides a cost-minimization analysis of 3 alternative supply strategies, with the aim of improving access to these essential diagnostic examinations for underserved populations in remote island settings.

Methods

We conducted a cost-minimization analysis over a 20-year horizon, comparing 3 scenarios in 4 island regions (Corsica, Crete, Sardinia, and Cyprus): (A) full reliance on imported radiopharmaceuticals, (B) local PET-only production via small cyclotrons, and (C) full local production via hybrid cyclotrons. Total costs included investment, fixed, and variable components, and were adjusted using purchasing power parity. Sensitivity analyses explored the effects of transport costs and demand levels.

Results

For all regions, local production became the least costly option beyond an initial annual threshold of approximately 650 annual PET examinations. Hybrid cyclotrons were slightly more cost minimizing than PET-only systems, especially in larger populations. For 3 of the 4 islands, local production dominated by year 3 to 8; for Cyprus, this occurred later, depending on demand and transport assumptions.

Conclusions

Local radiopharmaceutical production can be a cost-minimization strategy for improving PET services accessibility in island regions. This analysis may also serve as a transferable decision-making framework for other remote or underserved areas, such as the Canary Islands, rural Australia, or similar settings worldwide.

由于依赖外部生产的放射性药物和相关的后勤限制，许多岛屿地区获得正电子发射断层扫描（PET）服务的机会有限。本研究对3种替代供应策略进行了成本最小化分析，目的是改善偏远岛屿环境中服务不足人群获得这些基本诊断检查的机会。方法我们进行了20年的成本最小化分析，比较了4个岛屿地区（科西嘉岛、克里特岛、撒丁岛和塞浦路斯）的3种情况：(a)完全依赖进口放射性药物，(B)通过小型回旋加速器在当地仅生产pet，以及(C)通过混合回旋加速器在当地完全生产。总成本包括投资、固定和可变部分，并使用购买力平价进行调整。敏感性分析探讨了运输成本和需求水平的影响。结果对于所有地区来说，当地生产成为成本最低的选择，超过了每年大约650次PET检查的初始门槛。混合回旋加速器比pet系统的成本更低，特别是在较大的人群中。4个岛屿中有3个以3 ~ 8年为主要生产年份；对塞浦路斯来说，这发生得较晚，取决于需求和运输假设。结论海岛地区就地生产放射性药物是提高PET服务可及性的成本最小化策略。这一分析也可以作为其他偏远或服务不足地区的可转移决策框架，如加那利群岛、澳大利亚农村或世界各地的类似环境。

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引用次数: 0