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首页> 外文期刊>The British journal of psychiatry : >Drop out from treatment in the World Mental Health Survey initiative
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Drop out from treatment in the World Mental Health Survey initiative

机译：从世界心理健康调查倡议中脱落治疗

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The recent economic evaluation of an Improving Access to Psychological Therapies (IAPT) service conducted by Mukuria and colleagues1 is a welcome addition to the evidence base pertaining to this programme. This was a non-randomised comparison but it appears that the authors have used appropriate methods to control for differences between areas. A casual reading of the abstract conclusion would lead one to assume that IAPT is likely to be cost-effective. Indeed, the cost per quality-adjusted life year (QALY) is below the upper threshold used by the National Institute for Health and Clinical Excellence (NICE), and below the lower threshold in a sensitivity analysis where the EQ-5D was used. However, the cost per QALY is somewhat misleading. The most useful results from this study are the cost-effectiveness acceptability curves shown in Fig. 2. Here it is revealed that at the NICE upper threshold of ￡30 000 per QALY, there is about a 38% likelihood that IAPT is cost-effective, increasing to just over 50% if the EQ-5D is used to generate QALYs. If the lower threshold is used, then there is even less chance that IAPT is cost-effective. The overall conclusion of this paper should be based on Fig. 2 and it should be that on the basis of this study IAPT was probably not cost-effective.
机译：近期对Mukuria和同事进行的改善通勤的经济评价（IAPT）托管（IAPT）1是对本计划有关的证据基础的欢迎补充。这是一个非随机化的比较，但似乎作者使用适当的方法来控制区域之间的差异。休闲阅读抽象结论将导致人们认为IAPT可能具有成本效益。实际上，每个质量调整的生活年份（QALY）的成本低于国家健康和临床卓越（漂亮的临床卓越（漂亮），低于使用EQ-5D的敏感性分析中的较低阈值的上层阈值。但是，每个QALY的成本有点误导。本研究中最有用的结果是图2中所示的成本效益可接受曲线。在此显示，在每QALY每Q0 000英镑的良好上限阈值下，大约有38％的IAPT具有成本效益的可能性约为38％如果EQ-5D用于生成QALYS，则增加到超过50％。如果使用较低的阈值，那么IAPT甚至可能具有成本效益的可能性。本文的总体结论应基于图2，应该在本研究的基础上，IAPT可能不会具有成本效益。

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