摘要
目的:系统评价唐氏综合征无创产前检测技术(NIPT)的经济性。方法:检索与唐氏综合征NIPT经济学评价相关的文献,对纳入文章进行质量评价,运用描述性方法系统评价筛查策略的经济性。结果:根据纳入和排除的标准,两名评价人员独立评价文献质量后,共纳入15篇文献,文献质量得分在18分以上的占46.7%。其中有10项研究涉及将NIPT作为二次深度筛查提供给孕妇,12项研究涉及将NIPT提供给所有孕妇,3项研究涉及将NIPT提供给>35岁孕妇的筛查策略,1项研究涉及将NIPT作为产前诊断手段。目前将NIPT作为二次深度筛查提供给孕妇被认为是成本效果更好的策略。结论:NIPT是十分有应用前景的一种新技术,目前不推荐所有孕妇使用NIPT,如果其与当前的孕母血清学筛查更好地结合使用,作为条件筛查策略则经济性更好。随着未来价格的降低,它的经济性将会更为显著。
Objective： To systematically review the economic evaluations of non-invasive prenatal testing（ NIPT ） for Down syndrome. Methods： Literature review on economic evaluations of NIPT for Down syndrome were conducted, the quality of the literatures was assessed, and descriptive analysis was conducted to systematically evaluate the economic implications of prenatal screening strategy for Down syndrome. Results： Fifteen studies were included in the review based on the inclusion and exclusion criteria adopted. Two researchers independently evaluated the quality of the studies and 46.7% of the chosen studies were scored 18 points or higher. In 10 studies, NIPT was used as a contingent screening strategy for high-risk pregnancies following conventional screening. In 12 studies, NIPT was used for universal screening. Three studies used it as a hybrid strategy, in which NIPT was offered to all pregnant women aged over 35 years old. One study used NIPT was a prenatal screening strategy. Generally speaking, the contingent strategy was considered more costeffective. Conclusion： NIPT is a promising new technology for testing pregnant women for Down syndrome, contingent screening strategy could be cost-effective if properly designed and well integrated with existing screening strategies. Costs of using NIPT will likely to decrease as it becomes more widelv used and less costly in the future.
作者
许艳
李娜
明坚
庞伟明
陈英耀
XU Yan LI Na MING Jian PONG Raymood W CHEN Ying-yao(School of Public Health, Fudan University/Key Laboratory of Health Technology Assessment of National Health and Family Planning Commission/ Collaborative Innovation Center of Social Risks Governance in Health, Shanghai 200032, China Centre for Rural and Northern Health Research, Laurentian University, P3E 2C6 Ontario Canada ）.)
出处
《中国卫生资源》
北大核心
2017年第2期123-127,141,共6页
Chinese Health Resources
基金
2015年国家卫生计生委卫生技术评估项目资助
美国中华医学基金会卫生技术评估合作项目资助(13-153)
关键词
唐氏综合征
无创产前检测技术
经济性
系统评价
Down syndrome
non-invasive prenatal testing
economic assessment
systematic evaluation
