本文關(guān)鍵詞：基于貝葉斯方法兩種藥物治療腦梗塞（后遺癥期）成本效果模型構(gòu)建研究　出處：《北京中醫(yī)藥大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 貝葉斯 成本-效果 模型構(gòu)建 腦梗塞

【摘要】：目的：本研究旨在將貝葉斯理論(Bayes' theorem)評(píng)價(jià)方法引入腦梗塞藥物經(jīng)濟(jì)學(xué)(Pharmacoeconomics, PE)評(píng)價(jià)中。通過(guò)構(gòu)建貝葉斯效果、成本和成本-效果評(píng)價(jià)模型,并收集患者相關(guān)用藥信息數(shù)據(jù),評(píng)價(jià)藥物A和藥物B在有效性、經(jīng)濟(jì)性兩方面的綜合效果,對(duì)比貝葉斯方法和經(jīng)典統(tǒng)計(jì)學(xué)在藥物經(jīng)濟(jì)學(xué)研究中的差異,拓寬研究思路,豐富研究方法,以期更好地指導(dǎo)臨床合理用藥。方法：本研究選取總病例數(shù)104例,其中單獨(dú)使用藥物A病例71例,單用藥物B病例33例。以有效性和經(jīng)濟(jì)性為評(píng)價(jià)維度,分別選取美國(guó)國(guó)立衛(wèi)生研究院卒中量表(National Institute of Health stroke scale, NIHSS)評(píng)分改善有效率、中醫(yī)證候評(píng)分改善有效率和疾病治療成本3項(xiàng)指標(biāo)構(gòu)建貝葉斯藥物經(jīng)濟(jì)學(xué)評(píng)價(jià)模型。根據(jù)評(píng)價(jià)指標(biāo)的不同性質(zhì),選用不同的分布類型進(jìn)行抽樣模擬。結(jié)果：兩單獨(dú)用藥方案組在年齡、性別方面均具備可比性。貝葉斯方法分析可以得出：效果方面,NIHSS評(píng)分改善有效率,藥物A為0.7739[0.6711,0.8623],藥物B為0.8164[0.6709,0.9257],差值為-0.04243[-0.195,0.1272],無(wú)統(tǒng)計(jì)學(xué)差異；中醫(yī)證侯評(píng)分改善有效率,藥物A為0.8723[0.7859,0.9386],藥物B為0.4849[0.3192,0.6527],差值為0.3874[0.1998,0.569],差異有統(tǒng)計(jì)學(xué)意義。治療成本方面,藥物A為2758.0[2528.0,3006.0]元,藥物B為3474.0[3157.0,3821.1]元,差值為-715.4[-1131.0,-713.1]元,差異有統(tǒng)計(jì)學(xué)意義。成本-效果方面,NIHSS評(píng)分改善有效率成本-效果值,藥物A為3579.0[3094.0,4204.0],藥物B為4287.0.0[5251.0,11080.0]；中醫(yī)證侯評(píng)分改善有效率成本-效果值,藥物A為3169.0[2815.0,3610.0],藥物B為7411.0[5226.0,11080.0]。結(jié)論：藥物A與藥物B相比,藥物A的成本-效果優(yōu)于藥物B,因此應(yīng)優(yōu)先選擇藥物A作為腦梗塞的治療藥物,從而獲得較優(yōu)的經(jīng)濟(jì)效益。本研究基于貝葉斯原理,通過(guò)Winbugs軟件建立了藥物經(jīng)濟(jì)學(xué)中效果(有效率)、成本、成本-效果的模型,在一定程度上為藥物經(jīng)濟(jì)學(xué)分析提供了新的模型思路。貝葉斯方法綜合了先驗(yàn)信息、總體信息和樣本信息,結(jié)果直觀、精確、全面,是對(duì)經(jīng)典統(tǒng)計(jì)中藥物經(jīng)濟(jì)學(xué)分析的重要補(bǔ)充。
[Abstract]:Objective: the purpose of this study was to introduce the Bias theory (Bayes'theorem) evaluation method into the Pharmacoeconomics (PE) evaluation of cerebral infarction. Through the construction of Bayesian effect and effect evaluation of cost and cost model, and collect relevant information data in patients with medication, comprehensive effect evaluation of drug A and drug B in the effectiveness and economy of the two aspects, compared with Bayesian methods and classical statistics in pharmacoeconomics research in difference, broaden research ideas, enrich the research methods, in order to to better guide the clinical rational use of drugs. Methods: the total number of cases was selected in 104 cases, including 71 cases of drug A and 33 cases of single drug B. The effective and economical evaluation dimensions, were selected for the National Institutes of Health Stroke Scale (National Institute of Health stroke scale, NIHSS) score improved efficiency, TCM syndrome score improved treatment efficiency and disease cost in constructing the economic evaluation model of 3 indicators of Bayesian agents. According to the different properties of the evaluation index, different types of distribution are selected to carry out sampling simulation. Results: two the age and sex were comparable in the group of individual drugs. Bias analysis can be drawn: the effect, NIHSS score improved efficiency, drug A 0.7739[0.6711,0.8623], drug B 0.8164[0.6709,0.9257], difference -0.04243[-0.195,0.1272], no significant difference; the TCM syndrome score improved efficiency, drug A 0.8723[0.7859,0.9386], drug B 0.4849[0.3192,0.6527], the difference is 0.3874[0.1998,0.569], the difference was statistically significant. In terms of treatment cost, the drug A is 2758.0[2528.03006.0] yuan, the drug B is 3474.0[3157.03821.1] yuan, the difference is -715.4[-1131.0, -713.1] yuan, the difference is statistically significant. In terms of cost effectiveness, the NIHSS score improved the cost effective value of effective rate, the drug A was 3579.0[3094.04204.0], the drug B was 4287.0.0[5251.011080.0], the TCM syndrome score improved the effective rate cost effectiveness value, the drug A was 3169.0[2815.03610.0], and the drug B was 7411.0[5226.011080.0]. Conclusion: compared with drug B, the cost effectiveness of drug A is better than that of drug B, so we should give priority to the selection of drug A as a treatment drug for cerebral infarction, so as to get better economic benefits of drug A. Based on Bayes principle, this study established a pharmacoeconomic effect (efficiency), cost and cost-effectiveness model based on Bayesian theory, and to some extent, it provided a new model for Pharmacoeconomics analysis. Winbugs The Bias method integrates the prior information, the general information and the sample information. The result is intuitive, accurate and comprehensive, which is an important supplement to the pharmacoeconomics analysis of classical statistics.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R743.33

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