基于数据包络分析的原发性骨质疏松症不同治疗方案的疗效评价  

Effect Evaluation of Three Drugs Treatment of Primary Osteoporosis Based on Data Envelopment Analysis

作　　者：卢祖洵[1] 沈霖[2] 梁渊[1] 田怀谷[1] 梅乔生[1] 

机构地区：[1]华中科技大学同济医学院公共卫生学院社会医学系,430030 [2]华中科技大学同济医学院附属协和医院骨科

出　　处：《中国卫生统计》2007年第2期132-134,共3页Chinese Journal of Health Statistics

基　　金："十五"国家科技攻关计划资助(2001BA702B04)

摘　　要：目的从多投入-多产出的角度评价原发性骨质疏松症治疗方案的相对优劣,为老年疾病治疗方案的综合评价提供分析工具,并指导临床决策。方法三种治疗方案为VitD+钙剂、雌激素、二膦酸盐,投入指标为治疗总费用,产出指标为腰椎Ltotal、股骨颈Neck、Ward’s三角区骨密度和SF-36总得分的改变率。测量时间为基线一次、随访两次,随访间隔时间为半年。结果在第一次随访时二膦酸盐治疗组和雌激素治疗组的效率值θ=1,VitD+钙剂治疗组的效率值θ=0·9153;在第二次随访时,三种治疗方案的效率值均为θ=1。结论从短期效果来看,二膦酸盐治疗组和雌激素治疗组是等效的,而VitD+钙剂治疗组的疗效相对较差,但长期效果,三种治疗方案是等效的;相对临床上现有的方案评价方法而言,数据包络分析更为科学和实用,特别是在药物疗效评价和临床方案选择上具有较大的应用推广价值。Objective Evaluating clinic effect of three drugs treatment of primary osteoporosis by mult-input and multi-output comprehensive analysis and providing the scientific evidence for clinic decision-making. Methods The treatment plan to be evaluated was vit D ＋ Ca treatment, estrogen treatment and diphosphonates treatment. Input indexes is the total medical cost and the output indexes are the bone mineral densitY of lumbar （L1-4）, total lumbar, thighbone neck, Ward＇ s triangle area and SF- 36. The patients into the research cohort had been followed-up for 2 times, once every 6 months. Results The data of first follow-up show that DEA of both diphosphonates treatment and estrogen treatment were useful （θ= 1 ）, and DEA of Vit D ＋ Ca treatment was not useful （θ= 0. 929332）. The bone mineral densitY of Vit D ＋ Ca treatment could be improved further according to the relaxation variable, the second fonow-up showed that DEA of all the three treatments were useful, and all the relaxation variables were zero. Conclusion In short-term effect, the effect of estrogen treatment and dtphosphonates treatment is equivalent; Vit D ＋ Ca treatment is relative worst; but in long-term effect, the three treatment are equivalent. Relative to the existing technique of clinic evaluation, DEA is more scientific and applie, especially in drug evaluation and clinic therapeutics decision.

关 键 词：原发性骨质疏松症 数据包络分析 疗效评价 

分 类 号：R580[医药卫生—内分泌]