甲襞毛细血管镜和数字视网膜成像在糖尿病筛查中的卫生技术评估

IF 3.4 3区医学 Q1 HEALTH POLICY & SERVICES

Health Policy and Technology Pub Date : 2024-11-04 DOI:10.1016/j.hlpt.2024.100938

Vinaytosh Mishra , Zahiruddin Quazi Syed

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引用次数: 0

摘要

本研究旨在确定糖尿病筛查中医疗技术的评估标准，然后对数字视网膜成像（DRI）和指甲盖毛细血管镜（NFC）这两种技术进行健康技术评估（HTA）。在决策过程中，使用了一个由 10 位在医疗技术领域拥有 10 年以上经验的决策者组成的焦点小组。德尔菲法用于就比较标准和这些标准的替代方案达成共识。研究采用的抽样方法为非概率目的性抽样法。同时，伦理因素的重要性较低（0.03）。敏感性分析得出的结论是，决策对临床疗效和成本效益的变化很敏感。研究发现，作为通过血管变化早期检测糖尿病的一种选择，没有任何一种替代方案能够取代其他方案。结论本研究为医疗设备的多标准比较提供了一种方法。本研究使用 MACBETH 多标准决策工具评估了在糖尿病筛查中作为数字视网膜成像（DRI）替代品的甲皱毛细血管镜（NFC）。研究确定了五项关键评估标准：临床疗效、成本效益、患者需求、用户安全和伦理考虑。由经验丰富的医疗技术决策者组成的焦点小组对 NFC 和 DRI 进行了比较。结果表明，临床疗效和成本效益是最关键的因素，NFC 具有潜力，但并没有明显优于 DRI。敏感性分析强调了进一步研究的必要性，以验证 NFC 是一种有效的糖尿病筛查工具。

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Health technology assessment of nailfold capillaroscopy and digital retina imaging in diabetes screening

Aim

This study aims to identify the criteria for the evaluation of medical technologies in diabetes screening and then perform health technology assessment (HTA) for two technologies: digital retina imaging (DRI) and Nailfold Capillaroscopy (NFC).

Methods

A multicriteria decision-making tool measuring attractiveness using a categorical-based evaluation technique (MACBETH) was used to calculate and compare alternatives. A focus group of ten decision-makers with more than ten years of experience in health technology was used for the decision-making. The Delphi Method was used to get a consensus about comparing criteria and alternatives to these criteria. The sampling method used in the study was the nonprobability purposive sampling method.

Results

The study concluded that clinical efficacy (0.42) is the most important criterion for evaluating medical technologies, followed by cost-effectiveness (0.27). At the same time, ethical considerations were found to be less important (0.03). The sensitivity analysis concluded that the decision is sensitive to clinical efficacy and cost-effectiveness changes. The study found that none of the alternatives dominates others as an option for early detection of diabetes through vascular changes.

Limitations

This study primarily uses systemic literature review methods to identify criteria for evaluating alternatives. There may be additional criteria for evaluation.

Conclusion

This study provides an approach for a multicriteria comparison of medical devices. The study findings are useful for public health professionals and health policymakers.

Plain language summary

This study assesses nailfold capillaroscopy (NFC) as a substitute for digital retina imaging (DRI) in diabetes screening using the MACBETH multicriteria decision-making tool. The research identifies five key evaluation criteria: clinical efficacy, cost-effectiveness, patient needs, user safety, and ethical considerations. A focus group of experienced health technology decision-makers was used to compare NFC and DRI. Results indicate that clinical efficacy and cost-effectiveness are the most critical factors, with NFC showing potential but not significantly outperforming DRI. Sensitivity analyses highlight the need for further research to validate NFC as an effective diabetes screening tool.

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来源期刊

Health Policy and Technology Medicine-Health Policy

CiteScore

9.20

自引率

3.30%

发文量

审稿时长

88 days

期刊介绍： Health Policy and Technology (HPT), is the official journal of the Fellowship of Postgraduate Medicine (FPM), a cross-disciplinary journal, which focuses on past, present and future health policy and the role of technology in clinical and non-clinical national and international health environments. HPT provides a further excellent way for the FPM to continue to make important national and international contributions to development of policy and practice within medicine and related disciplines. The aim of HPT is to publish relevant, timely and accessible articles and commentaries to support policy-makers, health professionals, health technology providers, patient groups and academia interested in health policy and technology. Topics covered by HPT will include: - Health technology, including drug discovery, diagnostics, medicines, devices, therapeutic delivery and eHealth systems - Cross-national comparisons on health policy using evidence-based approaches - National studies on health policy to determine the outcomes of technology-driven initiatives - Cross-border eHealth including health tourism - The digital divide in mobility, access and affordability of healthcare - Health technology assessment (HTA) methods and tools for evaluating the effectiveness of clinical and non-clinical health technologies - Health and eHealth indicators and benchmarks (measure/metrics) for understanding the adoption and diffusion of health technologies - Health and eHealth models and frameworks to support policy-makers and other stakeholders in decision-making - Stakeholder engagement with health technologies (clinical and patient/citizen buy-in) - Regulation and health economics