Cost-effectiveness of population-based screening for chronic obstructive pulmonary disease in China: a simulation modeling study
Background - China has the highest disease burden of chronic obstructive pulmonary disease (COPD) in the world; however, the diagnosis rate remains low. Screening for COPD in the population may improve early diagnosis and long-term health outcomes for patients with COPD. In this study, we aimed to e...
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| Hauptverfasser: | , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
May 2024
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| In: |
The lancet. Regional Health. Western Pacific
Year: 2024, Jahrgang: 46, Pages: 1-13 |
| ISSN: | 2666-6065 |
| DOI: | 10.1016/j.lanwpc.2024.101065 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.lanwpc.2024.101065 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2666606524000592 
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| Verfasserangaben: | Qiushi Chen, Yiwen Fan, Ke Huang, Wei Li, Pascal Geldsetzer, Till Bärnighausen, Ting Yang, Chen Wang and Simiao Chen |
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| 245 | 1 | 0 | |a Cost-effectiveness of population-based screening for chronic obstructive pulmonary disease in China |b a simulation modeling study |c Qiushi Chen, Yiwen Fan, Ke Huang, Wei Li, Pascal Geldsetzer, Till Bärnighausen, Ting Yang, Chen Wang and Simiao Chen |
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| 520 | |a Background - China has the highest disease burden of chronic obstructive pulmonary disease (COPD) in the world; however, the diagnosis rate remains low. Screening for COPD in the population may improve early diagnosis and long-term health outcomes for patients with COPD. In this study, we aimed to evaluate the cost-effectiveness of population-based COPD screening policies in China. - Methods - We developed a microsimulation model that simulated incidence, natural history, and clinical management of COPD over a lifetime horizon among the general population aged 35-80 years in China. We evaluated population-based screening policies with different screening methods (one-step with COPD Screening Questionnaire or two-step with additional portable spirometer test) and frequencies (one-time or every 1-10 years). We calculated the incremental cost-effectiveness ratio (ICER) of the screening policies compared with the status quo (without screening) and identified the most cost-effective screening policy. Scenario and sensitivity analyses were performed to assess the impact of key parameters and the robustness of model results. - Findings - Compared with the status quo, all population-based COPD screening policies were cost-effective with estimated ICERs ranging between $8034 and $13,209 per quality-adjusted-life-year (QALY), all under the willingness-to-pay value of $38,441/QALY (three times China's gross domestic product per capita). A total of 0.39%-8.10% of COPD-related deaths and 0.58%-2.70% of COPD exacerbations were projected to be averted by COPD screening. Among all screening policies, annual two-step screening was the most cost-effective. Improving the linkage from screening to diagnosis and treatment could further increase population health benefits and the cost-effectiveness of COPD screening. - Interpretation - Population-based screening for COPD could be cost-effective in China. Offering public programs for COPD screening similar to existing preventive health services for other chronic diseases could be a promising strategy to improve population health outcomes and mitigate the disease burden of COPD in China. - Funding - Alexander von Humboldt Foundation, National Natural Science Foundation of China, CAMS Innovation Fund for Medical Science, Chinese Academy of Engineering project, and Horizon Europe. | ||
| 650 | 4 | |a Chronic obstructive pulmonary disease | |
| 650 | 4 | |a Cost-effectiveness analysis | |
| 650 | 4 | |a Microsimulation | |
| 650 | 4 | |a Population-based screening | |
| 650 | 4 | |a Public health policy | |
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| 700 | 1 | |a Huang, Ke |e VerfasserIn |4 aut | |
| 700 | 1 | |a Li, Wei |e VerfasserIn |4 aut | |
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| 700 | 1 | |a Chen, Simiao |e VerfasserIn |0 (DE-588)1138719242 |0 (DE-627)896263061 |0 (DE-576)492659265 |4 aut | |
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