对一项临床干预措施的全面评价应包括临床效果和卫生经济学两个方面 ,但由于种种原因 ,评价所需资料并非都能从科学性及论证力较强的随机临床对照试验或前瞻性研究中得到 ,特别是一些治疗措施远期效果的评价 ,往往无法在短期内进行前瞻性研究。而对一些已进行了随机对照临床试验的治疗方法 ,常常因试验期有限、并存在依从性及副作用的问题 ,仍不能确定理想的治疗策略 ,在这些情况下往往要借助模型分析来提供决策信息。例如对某种药物的远期效果进行经济学评价至少要在药物上市 3- 4年才能进行 ,而模型研究则在得到药物三期临床试验的结果之后即可进行。还有些新疗法的效果已得到设计完善的随机对照临床试验的证实 ,但在患病情况不同、期望寿命不同或经济背景不同的人群中应用可能产生不同的经济效果 ,应用模型分析可为这些研究结果的外推提供依据。目前应用模型进行临床决策分析的研究日益增多 ,方法越来越丰富 ,Markov模型即是近年来广泛应用于临床决策分析的一种 ,它特别适用于对慢性病或临床干预的远期效果进行评价 A comprehensive assessment of a clinical intervention should include both clinical and health economics, but not all of the information needed for the evaluation can be judged, for various reasons, from either a randomized controlled trial or a prospective study In the evaluation of the long-term effects of some treatment measures, often can not be prospectively conducted in the short term. However, for some randomized controlled clinical trials, the treatment methods are often limited by the limited duration of the trial and the problems of compliance and side effects. The ideal treatment strategy can not be determined. In these cases, model analysis is often used to provide decision information . For example, the economic evaluation of the long-term effects of a drug can take place at least 3-4 years after the drug is marketed, while the model studies are conducted after the results of the phase III clinical trial of the drug are obtained. Some new therapies have been validated by well-designed randomized controlled clinical trials but may have different economic effects in populations with different prevalences, different life expectancies, or different economic backgrounds. Applying model analysis to these studies Extrapolation of the results provided. At present, there are more and more studies on the application of clinical decision analysis model, the method is more and more rich, Markov model is widely used in clinical decision analysis in recent years, it is particularly suitable for evaluation of long-term effects of chronic diseases or clinical intervention