• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文学位 >Quantifying Uncertainty in the Efficacy of Vitamin K on Fractures in Postmenopausal Women: Economic Evaluation, Evidence Synthesis and Bayesian Meta- Analysis.
【24h】

Quantifying Uncertainty in the Efficacy of Vitamin K on Fractures in Postmenopausal Women: Economic Evaluation, Evidence Synthesis and Bayesian Meta- Analysis.

机译：量化绝经后妇女骨折中维生素K疗效的不确定性：经济评估，证据综合和贝叶斯Meta分析。

获取原文
获取原文并翻译 | 示例
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Vitamin K has a negligible effect on bone mineral density (BMD) and a large but uncertain effect on fractures. The three studies in the thesis explored uncertainty about the effect of vitamin K on fractures using the methods of economic evaluation and Bayesian meta-analysis.;In study 1, a Markov probabilistic microsimulation model was developed for a hypothetical cohort of 50-year-old postmenopausal women without osteoporosis. This was a fracture incidence-based model, populated with data from the literature. It was used to examine the cost-effectiveness of two supplementation strategies over a lifetime horizon. We compared vitamin K2 (or vitamin K1) concurrent with vitamin D3 and calcium versus vitamin D3 and calcium alone. Study 2 included a systematic review, and classical and Bayesian univariate meta-analyses to determine the efficacies of the K vitamins on BMD or fractures in current and future trials. Study 3 used Bayesian bivariate random-effects meta-analysis to jointly model the treatment effects on two correlated bone outcomes. We compared the estimates from the univariate and bivariate meta-analyses and explored how these results would change the conclusions of the cost-effectiveness analysis.;The strategies including vitamin K were highly cost-effective at willingness-to-pay of ;Our analyses found substantial uncertainty around the estimates of the vitamin K effect on fractures. We recommend against routine use of vitamin K for fracture prevention. Bayesian bivariate meta-analysis accounts for all available information and should be considered when the treatment effects are measured on two correlated outcomes.
机译：维生素K对骨矿物质密度（BMD）的影响可忽略不计，对骨折的影响很大但不确定。论文中的三项研究使用经济评估和贝叶斯荟萃分析方法探讨了维生素K对骨折的影响的不确定性。在研究1中，针对一个假设年龄为50岁的人群建立了马尔可夫概率微观模拟模型绝经后妇女没有骨质疏松症。这是一个基于骨折发生率的模型，其中填充了来自文献的数据。它用于检查两种补充策略在整个生命周期内的成本效益。我们比较了维生素K2（或维生素K1），维生素D3和钙与单独的维生素D3和钙。研究2包括系统评价，以及经典和贝叶斯单变量荟萃分析，以确定在当前和将来的试验中维生素K对BMD或骨折的疗效。研究3使用贝叶斯双变量随机效应荟萃分析对两个相关骨结局的治疗效果进行联合建模。我们比较了单变量和双变量荟萃分析的估计值，并探讨了这些结果将如何改变成本效益分析的结论。包括维生素K在内的策略在支付意愿方面具有很高的成本效益；我们的分析发现估计维生素K对骨折的影响存在很大的不确定性。我们建议您不要常规使用维生素K预防骨折。贝叶斯双变量荟萃分析说明了所有可用信息，在对两个相关结果进行治疗效果评估时应考虑使用贝叶斯双变量荟萃分析。

著录项

  • 作者

    Gajic-Veljanoski, Olga.;

  • 作者单位

    University of Toronto (Canada).;

  • 授予单位 University of Toronto (Canada).;
  • 学科 Obstetrics.;Womens studies.;Health care management.
  • 学位 Ph.D.
  • 年度 2013
  • 页码 290 p.
  • 总页数 290
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号