目的:评价尼妥珠单抗联合吉西他滨(nimotuzumab plus gemcitabine,NG)一线治疗局部晚期或转移性K-Ras野生型胰腺癌患者的经济性,为相关卫生决策提供参考。方法:基于一项多中心、随机、开放标签的Ⅲ期临床试验(NCT02395016)数据构建分区...目的:评价尼妥珠单抗联合吉西他滨(nimotuzumab plus gemcitabine,NG)一线治疗局部晚期或转移性K-Ras野生型胰腺癌患者的经济性,为相关卫生决策提供参考。方法:基于一项多中心、随机、开放标签的Ⅲ期临床试验(NCT02395016)数据构建分区生存模型,模拟时限为5年,循环周期为28 d。比较NG方案和吉西他滨(gemcitabine,G)方案一线治疗局部晚期或转移性K-Ras野生型胰腺癌的经济性。以质量调整生命年(quality-adjusted life year,QALY)作为产出指标并计算增量成本-效果比(incremental cost-effectiveness ratio,ICER),采用单因素敏感性分析及概率敏感性分析评价模型参数变化对结果稳健性的影响。结果:基础分析结果显示,相较于G方案,NG方案人均成本增加304806.15元,人均效用增加0.16 QALYs,ICER为1865405.26元/QALY,高于本研究设定的268074.00元/QALY的意愿支付(willingness-to-pay,WTP)阈值。单因素敏感性分析结果表明,尼妥珠单抗的成本、肿瘤稳定状态效用和肿瘤进展状态效用对ICER的影响较大。概率敏感性分析结果显示,在WTP阈值为268074.00元/QALY时,NG方案具有经济性的概率为0。结论:与G方案相比,NG方案作为一线药物治疗局部晚期或转移性K-Ras野生型胰腺癌不具有经济性。展开更多
There is a strong demand for accurate estimates of long-term changes in soil organic carbon(SOC)with different agricultural practices under different soil and climate conditions.A process and analytic model,K-model,in...There is a strong demand for accurate estimates of long-term changes in soil organic carbon(SOC)with different agricultural practices under different soil and climate conditions.A process and analytic model,K-model,including a non-compartmental algorithm of soil carbon decomposition,was developed to simulate the changes of SOC under different cropping and soil management practices.This study evaluates the performance of K-model by comparing its predictions on SOC with measurements and predictions of CENTURY model,which is widely used for the similar purposes.Both K-model and CENTURY can predict the dynamics of SOC when site-specific soil and climate data are used to initialize simulations.Very similar annual carbon decomposition rates were simulated by the single carbon pool K-model and the 3-carbon pool CENTURY model.However,compared with experimental measurements of SOC,K-model produces relative smaller errors than CENTURY(<0.1 kg C m-2 vs.0.08-0.48 kg C m-2,and within±5%vs.±5%-45%),mainly resulting from smaller biases of predicted crop production.When detailed site-specific soil and climate data are not available for initialization and feeding the running of model,K-model can still reasonably predict the dynamics of SOC with its auto-correction function,but CENTURY produces poor results.In comparison with measurements,K-model has improved capacities to predict the effects of chemical fertilizer,manure application,residue management and fallow on SOC dynamics.展开更多
文摘目的:评价尼妥珠单抗联合吉西他滨(nimotuzumab plus gemcitabine,NG)一线治疗局部晚期或转移性K-Ras野生型胰腺癌患者的经济性,为相关卫生决策提供参考。方法:基于一项多中心、随机、开放标签的Ⅲ期临床试验(NCT02395016)数据构建分区生存模型,模拟时限为5年,循环周期为28 d。比较NG方案和吉西他滨(gemcitabine,G)方案一线治疗局部晚期或转移性K-Ras野生型胰腺癌的经济性。以质量调整生命年(quality-adjusted life year,QALY)作为产出指标并计算增量成本-效果比(incremental cost-effectiveness ratio,ICER),采用单因素敏感性分析及概率敏感性分析评价模型参数变化对结果稳健性的影响。结果:基础分析结果显示,相较于G方案,NG方案人均成本增加304806.15元,人均效用增加0.16 QALYs,ICER为1865405.26元/QALY,高于本研究设定的268074.00元/QALY的意愿支付(willingness-to-pay,WTP)阈值。单因素敏感性分析结果表明,尼妥珠单抗的成本、肿瘤稳定状态效用和肿瘤进展状态效用对ICER的影响较大。概率敏感性分析结果显示,在WTP阈值为268074.00元/QALY时,NG方案具有经济性的概率为0。结论:与G方案相比,NG方案作为一线药物治疗局部晚期或转移性K-Ras野生型胰腺癌不具有经济性。
基金financial support from EPCOR,Carbon Reduction Offset Project Ltd.and AARI,and critical review by Karen Haugen-Kozyra,Tom Goddard,Tony Brierley,Len Kryzanowski,Sheilah Nolan,Richard Harrow and Keith Anderson.
文摘There is a strong demand for accurate estimates of long-term changes in soil organic carbon(SOC)with different agricultural practices under different soil and climate conditions.A process and analytic model,K-model,including a non-compartmental algorithm of soil carbon decomposition,was developed to simulate the changes of SOC under different cropping and soil management practices.This study evaluates the performance of K-model by comparing its predictions on SOC with measurements and predictions of CENTURY model,which is widely used for the similar purposes.Both K-model and CENTURY can predict the dynamics of SOC when site-specific soil and climate data are used to initialize simulations.Very similar annual carbon decomposition rates were simulated by the single carbon pool K-model and the 3-carbon pool CENTURY model.However,compared with experimental measurements of SOC,K-model produces relative smaller errors than CENTURY(<0.1 kg C m-2 vs.0.08-0.48 kg C m-2,and within±5%vs.±5%-45%),mainly resulting from smaller biases of predicted crop production.When detailed site-specific soil and climate data are not available for initialization and feeding the running of model,K-model can still reasonably predict the dynamics of SOC with its auto-correction function,but CENTURY produces poor results.In comparison with measurements,K-model has improved capacities to predict the effects of chemical fertilizer,manure application,residue management and fallow on SOC dynamics.
