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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Outcomes and costs of febrile neutropenia: adventures in the science and art of treatment choices.
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Outcomes and costs of febrile neutropenia: adventures in the science and art of treatment choices.

机译：高热性中性粒细胞减少症的结果和费用：治疗选择的科学和艺术冒险。

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摘要

The choice of therapy for febrile neutropenia is complex, because of the large number of options that are similar in safety and efficacy. However, there are a number of outcomes that may be useful when these choices have to be made. It is generally agreed that infection-related mortality is too rare an event, with the availability of modern antibiotics, to be of general use in treatment choices. Response to initial therapy may be useful, but differences among regimens in recent randomized trials only occasionally reach statistical significance, despite adequate power and sample size. The time to clinical response has been shown to vary significantly among otherwise similar regimens and may be very useful when response-based choices are made. Ideally, clinical and policy decisions should be based on a combined evaluation of outcomes and cost. In the case where clinical outcomes are the same for more than one regimen, cost-minimization analysis is appropriate. In the case where clinical outcomes differ, cost-effectiveness or cost-utility is an appropriate measure on which to base decisions. The cost of therapy can be easily estimated by using the number and average cost of days of hospitalization as a surrogate. A decision-analytic model for febrile neutropenia is proposed.
机译：高热性中性粒细胞减少症的治疗选择很复杂，因为在安全性和功效上有很多相似的选择。但是，当必须做出这些选择时，有许多结果可能会有用。人们普遍认为，随着现代抗生素的普及，与感染有关的死亡率太罕见了，因此不能普遍用于治疗选择。对初始疗法的反应可能有用，但尽管有足够的功效和样本量，但近期随机试验中方案之间的差异仅偶尔达到统计学意义。研究表明，在其他类似方案中，达到临床反应的时间会有很大差异，并且在做出基于反应的选择时可能非常有用。理想情况下，临床和政策决策应基于对结果和成本的综合评估。如果一种以上治疗方案的临床结果相同，则进行成本最小化分析是适当的。在临床结果不同的情况下，成本效益或成本效用是作为决策依据的适当措施。通过将住院天数和平均费用作为替代指标，可以轻松估算治疗费用。提出了发热性中性粒细胞减少症的决策分析模型。

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