TY -非盟的阿尔伯克基de Almeida费尔南多AU - Corro拉莫斯,艾萨克AU - Al Maiwenn AU - Rutten-van Molken,莫林PY - 2022 DA - 2022/8/4 TI -家庭远程控制和诊断算法在荷兰心力衰竭的管理:成本效益分析乔- JMIR有氧运动SP - e31302六世- 6 - 2 KW -离散事件仿真KW -成本效益KW -早期预警系统KW -家里遥控KW -诊断算法KW -心脏衰竭AB -背景:心力衰竭是一个主要的健康问题，与患者的显著发病率、死亡率和生活质量降低有关。家庭远程监护(HTM)有助于对疾病体征和症状进行频繁或持续的评估，它已被证明可以通过让患者参与自己的护理来提高依从性，并通过促进早期发现临床重大变化来防止紧急入院。诊断算法(DAs)是一种预测数学关系，它利用广泛收集的数据来计算特定事件的可能性，并使用此输出来对患者的治疗进行优先排序。目的:本研究旨在评估HTM和DA在荷兰心力衰竭管理中的成本效益。分析了三种干预措施:常规护理、HTM和HTM加DA。方法:采用先前发表的离散事件模拟模型。基础案例分析是根据荷兰经济评价准则进行的。进行信息分析的敏感性、情景和价值。特别关注DA在不同级别的事件预测诊断准确性和不同患者亚组的成本效益。 Results: HTM plus the DA extendedly dominates HTM alone, and it has a deterministic incremental cost-effectiveness ratio compared with usual care of €27,712 (currency conversion rate in purchasing power parity at the time of study: €1=US $1.29; further conversions are not applicable in cost-effectiveness terms) per quality-adjusted life year. The model showed robustness in the sensitivity and scenario analyses. HTM plus the DA had a 96.0% probability of being cost-effective at the appropriate €80,000 per quality-adjusted life year threshold. An optimal point for the threshold value for the alarm of the DA in terms of its cost-effectiveness was estimated. New York Heart Association class IV patients were the subgroup with the worst cost-effectiveness results versus usual care, while HTM plus the DA was found to be the most cost-effective for patients aged <65 years and for patients in New York Heart Association class I. Conclusions: Although the increased costs of adopting HTM plus the DA in the management of heart failure may seemingly be an additional strain on scarce health care resources, the results of this study demonstrate that, by increasing patient life expectancy by 1.28 years and reducing their hospitalization rate by 23% when compared with usual care, the use of this technology may be seen as an investment, as HTM plus the DA in its current form extendedly dominates HTM alone and is cost-effective compared with usual care at normally accepted thresholds in the Netherlands. SN - 2561-1011 UR - https://cardio.www.mybigtv.com/2022/2/e31302 UR - https://doi.org/10.2196/31302 UR - http://www.ncbi.nlm.nih.gov/pubmed/35925670 DO - 10.2196/31302 ID - info:doi/10.2196/31302 ER -