Originales
Análisis coste-efectividad de tipo probabilístico del tratamiento de la apnea del sueño
Probabilistic cost-effectiveness analysis of the treatment of sleep apnea
Javier Mara,
, Santiago Gutiérrez-Morenob, Jim Chilcottc
Autor para correspondencia
jmar@hmon.osakidetza.net
Correspondencia: Dr. Javier Mar. Unidad de Gestión Sanitaria. Hospital Alto Deba. C/Zaldispe, s/n. 20500 Mondragón. Gipuzkoa. España.
Correspondencia: Dr. Javier Mar. Unidad de Gestión Sanitaria. Hospital Alto Deba. C/Zaldispe, s/n. 20500 Mondragón. Gipuzkoa. España.
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996
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"jmar@hmon.osakidetza.net" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Santiago" "apellidos" => "Gutiérrez-Moreno" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Jim" "apellidos" => "Chilcott" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Gestión Sanitaria, Hospital Alto Deba, Mondragón, Gipuzkoa, España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Evaluación y Planificación, Servicio Canario de Salud, Santa Cruz de Tenerife, Tenerife, España" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "School of Health and Related Research, University of Sheffield, Sheffield, Reino Unido." "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. Javier Mar. Unidad de Gestión Sanitaria. Hospital Alto Deba. C/Zaldispe, s/n. 20500 Mondragón. Gipuzkoa. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Probabilistic cost-effectiveness analysis of the treatment of sleep apnea" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-01-11" "fechaAceptado" => "2005-03-11" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec14021" "palabras" => array:4 [ 0 => "Síndrome de apnea obstructiva del sueño" 1 => "Tratamiento" 2 => "Análisis coste-efectividad" 3 => "Simulaciones de Monte Carlo" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec14022" "palabras" => array:4 [ 0 => "Obstructive sleep apnea syndrome" 1 => "Treatment" 2 => "Cost-effectiveness analysis" 3 => "Monte Carlo simulations" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">En este trabajo se presenta la aplicación del análisis coste-efectividad de tipo probabilístico al tratamiento con presión continua en la vía respiratoria por vía nasal (<span class="elsevierStyleItalic">nasal continuous positive airway pressure</span>, nCPAP) del síndrome de la apnea obstructiva del sueño (SAOS).</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">La base del estudio es un modelo de Markov probabilístico. Éste se caracteriza porque las variables se introducen en forma de distribuciones. El modelo se procesa mediante 2.000 simulaciones de Monte Carlo, cada una de las cuales calcula el coste y la efectividad incrementales. El resultado se analiza mediante el plano coste-efectividad, la curva de aceptabilidad, el beneficio neto y el valor esperado de la información perfecta.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La razón coste-efectividad del tratamiento con nCPAP media calculada es de 5.480 €/año de vida ajustado por calidad (AVAC). Utilizando como umbral de eficiencia la cifra de 30.000 €/AVAC, el análisis probabilístico muestra que en el 98,5% de las simulaciones el tratamiento con nCPAP es una práctica eficiente. El valor esperado de la información perfecta muestra que el parámetro que origina más incertidumbre en el resultado es la ganancia en calidad de vida producida por el tratamiento.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El análisis de tipo probabilístico ratifica el resultado de los estudios deterministas que caracterizan el tratamiento con nCPAP como una intervención eficiente. La ventaja añadida es que permite situar la incertidumbre en términos cuantitativos; en este caso la probabilidad de equivocarse es inferior al 5%. Además, el estudio muestra que para reducir esa incertidumbre la investigación debe centrarse en la mejora de la información referente a la calidad de vida.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To describe the application of a probabilistic costeffectiveness analysis to nasal continuous positive airway passage (nCPAP) treatment of obstructive sleep apnea syndrome (OSAS).</p> <span class="elsevierStyleSectionTitle">Material and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">The probabilistic model was constructed from a discrete Markov model. This probabilistic approach is characterized by the introduction of variables as probability distributions. The model performed 2,000 Monte Carlo simulations, and incremental costs and effectiveness were calculated in each. The results were analyzed through the costeffectiveness plane, the acceptability curve, the net benefit rule, and the expected value of perfect information (EVPI).</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The mean cost-effectiveness ratio for nCPAP treatment was 5,480 €/QALY (quality-adjusted life year). Using an acceptability threshold of 30,000 €/QALY, the probabilistic analysis showed that nCPAP was the optimal treatment in 98.5% of the simulations. The EVPI showed that the parameter causing greatest uncertainty in the final results was the quality of life gain through nCPAP treatment.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The results of our probabilistic analysis are endorsed by previous deterministic studies confirming that nCPAP treatment of OSAS is the most cost-effective strategy. An additional advantage of probabilistic analysis is that it allows uncertainty to be quantified; in the present case the probability of making the wrong decision was below 5%. Furthermore, this study reveals that to reduce uncertainty, research should center on improving information on quality of life.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The journal's policy on cost-effectiveness analyses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.P. Kassirer" 1 => "M. Angell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199409083311009" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1994" "volumen" => "331" "paginaInicial" => "669" "paginaFinal" => "670" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7695687" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cost-effectiveness in health and medicine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.R. Gold" 1 => "J.E. Siegel" 2 => "L.B. Russell" 3 => "M.C. Weinstein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1996" "editorial" => "Oxford University Press" "editorialLocalizacion" => "Nueva York" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "In search of power and significance: issues in the design and analysis of stochastic cost-effectiveness studies in health care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B.J. O’Brien" 1 => "M.F. Drummond" 2 => "R.J. Labelle" 3 => "A. Willan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Care" "fecha" => "1994" "volumen" => "32" "paginaInicial" => "150" "paginaFinal" => "163" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8302107" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Probabilistic analysis of cost-effectiveness models: choosing between treatment strategies for gastroesophageal reflux disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.H. Briggs" 1 => "R. Goeree" 2 => "G. Blackhouse" 3 => "B. O’Brien" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Decis Making" "fecha" => "2002" "volumen" => "22" "paginaInicial" => "290" "paginaFinal" => "308" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12150595" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guide to the methods of technology appraisal" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "National Institute for Clinical Excellence" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2004" "editorial" => "NICE" "editorialLocalizacion" => "Londres" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bayesian value-of-information analysis: an aplication to a policy model of Alzheimer's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Claxton" 1 => "P.J. Neumann" 2 => "S. Araki" 3 => "M.C. Weinstein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Technol Asses Health Care" "fecha" => "2001" "volumen" => "17" "paginaInicial" => "38" "paginaFinal" => "55" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Análisis de la incertidumbre en las evaluaciones económicas de intervenciones sanitarias" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "por el grupo ECOMED" "etal" => false "autores" => array:6 [ 0 => "C. Rubio-Terrés" 1 => "C. Cobo" 2 => "J.A. Sacristán" 3 => "L. Prieto" 4 => "J. Del Llano" 5 => "X. Badía" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2004" "volumen" => "122" "paginaInicial" => "668" "paginaFinal" => "674" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sleep apnea syndromes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Guilleminault" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "editores" => "W.C.Dement" "serieVolumen" => "Vol. 11" "serieTitulo" => "Kroc Foundation series" "serieFecha" => "1978" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical features and evaluation of obstructive sleep apnea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Guilleminault" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Principles and practice of sleep medicine" "paginaInicial" => "552" "paginaFinal" => "558" "serieFecha" => "1989" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Population based study of sleep disordered breathing as a risk factor for hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Young" 1 => "P. Peppard" 2 => "M. Palta" 3 => "K. Mae Hla" 4 => "L. Finn" 5 => "B. Morgan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1997" "volumen" => "157" "paginaInicial" => "1746" "paginaFinal" => "1752" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The association between sleep apnea and the risk of traffic accidents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Terán-Santos" 1 => "A. Jiménez-Gómez" 2 => "J. Cordero-Guevara" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199903183401104" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1999" "volumen" => "340" "paginaInicial" => "847" "paginaFinal" => "851" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10080847" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quality adjusted life years added by treatment of obstructive sleep apnea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Tousignant" 1 => "M.G. Cosio" 2 => "R.D. Levy" 3 => "P.A. Groome" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Sleep" "fecha" => "1994" "volumen" => "17" "paginaInicial" => "52" "paginaFinal" => "60" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8191203" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The occurrence of sleep-disordered breathing among middle-aged adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Young" 1 => "M. Palta" 2 => "J. Dempsey" 3 => "J. Skatrud" 4 => "S. Webwe" 5 => "S. Badr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199304293281704" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1993" "volumen" => "328" "paginaInicial" => "1230" "paginaFinal" => "1235" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8464434" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamiento del síndrome de las apneas-hipopneas durante el sueño" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Montserrat" 1 => "J. Amilibia" 2 => "F. Barbe" 3 => "F. Capote" 4 => "J. Duran" 5 => "N.G. Mangado" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "1998" "volumen" => "34" "paginaInicial" => "204" "paginaFinal" => "206" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9611656" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cost-utility of three approaches to the diagnosis od sleep apnea: polisomnography, home testing and empirical therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.D. Chervin" 1 => "D.L. Murman" 2 => "B.A. Malow" 3 => "V. Totten" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1999" "volumen" => "130" "paginaInicial" => "496" "paginaFinal" => "505" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10075617" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The cost-effectiveness of nCPAP treatment in patients with moderate-tosevere obstructive sleep apnoea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Mar" 1 => "J.R. Rueda" 2 => "J. Durán-Cantolla" 3 => "C. Schechter" 4 => "J. Chilcott" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2003" "volumen" => "21" "paginaInicial" => "515" "paginaFinal" => "522" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12662011" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Markov models in medical decision making: a practical guide" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F.A. Sonnenberg" 1 => "R. Beck" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Decis Making" "fecha" => "1993" "volumen" => "13" "paginaInicial" => "322" "paginaFinal" => "338" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8246705" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Blood pressure, stroke and coronary heart disease (I). Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. MacMahon" 1 => "R. Peto" 2 => "J. Cutler" 3 => "R. Collins" 4 => "P. Sorlie" 5 => "J. Neaton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1990" "volumen" => "335" "paginaInicial" => "765" "paginaFinal" => "774" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1969518" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Blood pressure, stroke and coronary heart disease (II). Short term reductions in blood pressure: overview of randomised drug trials in their epidemiological context" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Collins" 1 => "R. Peto" 2 => "S. MacMahon" 3 => "P. Hebert" 4 => "N.H. Fiebach" 5 => "K.A. Eberlein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1990" "volumen" => "335" "paginaInicial" => "827" "paginaFinal" => "838" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1969567" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inroduction: Bayesian approaches to technology assessment and decision making" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B.R. Luce" 1 => "Y. Tina Shih" 2 => "C. Claxton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Technol Assess Healt Care" "fecha" => "2001" "volumen" => "17" "paginaInicial" => "1" "paginaFinal" => "5" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Net health benefits: a new framework for the analysis of uncertainty in cost-effectiveness analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.A. Stinnett" 1 => "J. Mullahy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Decis Making" "fecha" => "1998" "volumen" => "18" "numero" => "Supl 2" "paginaInicial" => "68" "paginaFinal" => "80" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "¿Qué es una tecnología sanitaria eficiente en España?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.A. Sacristán" 1 => "J. Oliva" 2 => "J. Del Llano" 3 => "L. Prieto" 4 => "J.L. Pinto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Gac Sanit" "fecha" => "2002" "volumen" => "4" "paginaInicial" => "334" "paginaFinal" => "343" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Five-hundred life-saving interventions and their cost-effectiveness" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O.T. Tengs" 1 => "M.E. Adams" 2 => "J.S. Pliskin" 3 => "D. Gelb Safran" 4 => "J.E. Siegel" 5 => "M.C. Weinstein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Risk Anal" "fecha" => "1995" "volumen" => "15" "paginaInicial" => "369" "paginaFinal" => "390" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7604170" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How attractive does a new technology have to be to warrant adoption and utlizacion? Tentative guidelines for using clinical and economic evaluation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Laupacis" 1 => "D. Feeny" 2 => "A.S. Detsky" 3 => "P.X. Tugwell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Can Med Assoc J" "fecha" => "1992" "volumen" => "146" "paginaInicial" => "473" "paginaFinal" => "481" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Which is more important for the efficiency of hypertension treatment? The hypertension stage, the type of drug or the therapeutic compliance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Mar" 1 => "F. Rodríguez-Artalejo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Hypertens" "fecha" => "2000" "volumen" => "19" "paginaInicial" => "149" "paginaFinal" => "155" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11204296" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cost-effectiveness of cardiovascular prevention programs in Spain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Plans-Rubió" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Technol Assess Health Care" "fecha" => "1998" "volumen" => "14" "paginaInicial" => "320" "paginaFinal" => "330" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9611906" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/02139111/0000002000000001/v2_201301241556/S0213911106714510/v2_201301241556/es/main.assets" "Apartado" => array:4 [ "identificador" => "764" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02139111/0000002000000001/v2_201301241556/S0213911106714510/v2_201301241556/es/main.pdf?idApp=WGSE&text.app=https://gacetasanitaria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911106714510?idApp=WGSE" ]
Información del artículo
ISSN: 02139111Idioma original: Español
DOI:10.1157/13084127
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