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卫生经济决策模型(马尔可夫模型)已被广泛用于对临床试验的成本-效果,成本-效益,及成本-效用中的评价。建立此模型需要确定以下的参数和疾病的基本情况:疾病的演变状态马尔可夫链;临床试验的干预措施,干预人群和干预结果;疾病的初始概率,转移概率和死亡概率;健康效用值和治疗疾病的相关直接成本,间接成本和无形成本;需要做敏感度分析各值的变化范围。通过相关参数确定建立马尔可夫模型计算出相关期望寿命年和成本,而测算出相关效果,效益和效用值,最终对短期的临床试验效果进行长期临床效果的推测,从而给决策者提供相关的依据,还可对疾病的发病率和死亡率进行长期预测,从而为制定出干预疾病的防治提出相关的科学依据,最后还可对疾病的自然史进行估计,为疾病的研究提供科学资料。马尔可夫模型在相关疾病的发病推测和干预措施的卫生经济学评价上有广泛的实用性和不可替代的地位。
The health economic decision model (Markov model) has been widely used to evaluate the cost-effectiveness, cost-benefit, and cost-effectiveness of clinical trials. The establishment of this model requires the following parameters and the basic condition of the disease: Markov chain of evolution of the disease; clinical trial interventions, intervention populations and intervention outcomes; initial probability of disease, transition probability and probability of death; health utility values and Direct costs, indirect costs, and intangible costs associated with treating the disease; sensitivity analysis is needed to determine the range of variability of each value. Through establishing the Markov model by the relevant parameters and calculating the related life expectancy years and the costs, the related effects, benefits and utility values are calculated, and finally the long-term clinical effects of the short-term clinical trial effects are estimated, so as to provide decision makers with relevant Based on this, we can make long-term prediction on the morbidity and mortality of the disease so as to provide scientific basis for formulating the prevention and treatment of the intervention disease. Finally, we can estimate the natural history of the disease and provide scientific information for the research of the disease. The Markov model has a wide range of practicability and irreplaceable value in the evaluation of health economics about the speculation of related diseases and the interventions.