간접비교를 통한 보건의료기술의 유용성 평가에서  분석결과의 타당성 확보를 위한 조건

한서경; 김윤희; 안정훈; 장은진; 강수희; 김선희

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자료유형: 학술저널

저자정보: 한서경 김윤희 안정훈 장은진 강수희 김선희

저널정보: 한국보건정보통계학회 보건정보통계학회지 보건정보통계학회지 제36권 제2호

발행연도: 2011.1

수록면: 25 - 35 (11page)

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Objectives: The study aims to identify and discuss the concept of the key assumption on which the indirect comparisons rely and to illustrate a practical approach to assure the validity. Methods: We firstly reviewed the theoretical background of the indirect comparisons and then suggested how the key assumptions can be assessed and accounted for using an example of common reference based indirect comparison. Results: The fundamental assumption behind the synthesized comparative effect obtained by indirect comparison is that the same effect would still be obtainable if it was directly measured in all of the trials that constitute the indirect comparison. An illustrative analysis demonstrated that conducting an indirect comparison without a meticulous assessment for the exchangeability could mislead the conclusion on the comparative effectiveness. Conclusions: Head-to-head trials could provide the most valid estimate of the comparative effect of a healthcare intervention. When competing interventions have not been evaluated in direct randomized trials or there is little available source by those trials, indirect comparisons may be utilized to provide an estimate of the comparative effect. However,the limitations also need to be highlighted, since the indirect comparison methodology relies upon certain important but conceptual and essentially unverifiable key assumption.

#Indirect comparison #Health technology assessment #Exchangeability

참고문헌 (21)

참고문헌 신청

Bucher HC / 1997 / The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials / J Clin Epidemiol 50 : 683 ~ 691

Caldwell DM / 2005 / Simultaneous comparison of multiple treatments: combining direct and indirect evidence / BMJ 331 : 897 ~ 900

Commonwealth of Australia Pharmaceutical Benefits Advisory Committee / 2008 / Guidelines for preparing submissions to the Pharmaceutical Benefits Advisory Committee (Version 4.3)

Cooper NJ / 2004 / Comprehensive decision analytical modelling in economic evaluation: a Bayesian approach / Health Econ 13 : 203 ~ 226

Glenny AM / 2005 / Indirect comparisons of competing interventions / Health Technol Assess 9 : 1 ~ 134