1.Measurement and algorithm of healthy life expectancy: a scoping review
Wanqi WANG ; Jinghan QU ; Mengze LIU ; Minrui LI ; Boying ZANG ; Junwen ZHOU ; Houyu ZHAO ; Rui ZHANG ; Yunning LIU ; Lijun WANG ; Xia WAN ; Feng SUN ; Jing WU
Chinese Journal of Epidemiology 2022;43(12):1986-1994
Objective:Healthy life expectancy (HLE), which combines life expectancy with health, is an essential comprehensive measure of life length and quality. This article aimed to systematically review the methods for defining and measuring HLE and describe application studies published, providing a reference for decision makers to select and develop methods suitable for China's conditions to measure HLE.Methods:Seven Chinese and English literature databases were searched up to May 7, 2022, and several related reviews and bibliography were manually retrieved. Systematic reviews and empirical research were included concerning HLE indicators and measurement of HLE. Information including the study area, type of the study, study population, HLE index, measurement method, data sources, and results from application studies published in the last five years were extracted. The evolution of the definition of HLE, the scope of different indicators, the measurement scale of health, and measurement methods, were all collected. Results of the empirical research related to measurement methods of indicators were summarized. The study followed the scoping review framework and was written according to the PRISMA-ScR statement.Results:A total of 84 articles were included, including 13 reviews, 17 original studies related to HLE index definition, ten original studies related to index measurement, and 44 empirical studies conducted in the past five years. There were as many as 20 indicators related to HLE, and each scale had its emphasis. A total of ten methods measuring HLE were identified, which vary in the definition of health, whether using weight, and the data type. The most commonly used indicators in the past five years were disability-free life expectancy and HLE. For the method of HLE calculation, Sullivan's method was mainly used for cross-sectional data, and the multistate life table was mainly used for longitudinal data.Conclusions:There are various definitions and measurement methods of HLE, but none are suitable for all scenarios. To summarize the HLE concept, health evaluation techniques, measurement methods, and application studies published worldwide can provide a reference for the localization of HLE measurement in China.
2.Current situation of remote pharmaceutical care at home and abroad
Ziran NIU ; Yang HU ; Xuelian YAN ; Jinghan QU ; Rongji LIU ; Liping DU ; Ziyu BAI ; Jiantao LI ; Xiaoli DU ; Bo ZHANG
China Pharmacy 2022;33(16):2028-2031
Remote pharmaceutical care refers to the process that pharmacists provide pharmaceutical care to patients remotely through information technology. Remote pharmaceutical care in China starts late and develops slowly. Therefore ,this paper discusses the pharmaceutical care modes that pharmacists at home and abroad can provide under the remote mode by collecting literature. The results show that foreign remote pharmaceutical care starts early and is relatively mature. The service mainly included remote follow-up and intervention ,24-hour online prescription and order review ,24-hour online drug reorganization ,and guidance on rational drug use in remote areas or community hospitals. The service population covers patients with cardiovascular disease , diabetes,asthma,AIDS and so on. Some hospitals have established an integrated pharmaceutical care system of “Internet+Medical Consortium”in China ,with which pharmacists can provide patients with pharmaceutical care such as remote follow-up and intervention,drug consultation and so on. With the promotion of telemedicine ,domestic pharmacists can gradually expand the scope of services ,expand pharmaceutical services such as remote consultation and remote popular science push ,and realize the sharing of high-quality pharmaceutical care for the whole people.
3.Comprehensive Clinical Evaluation of Nusinersen Based on Multi-criteria Decision Analysis Method
Jinghan QU ; Xin LIU ; Xin TIAN ; Pengjiao AN ; Tingting XU ; Bo ZHANG
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1083-1090
To provide a theoretical basis for different drug decision-making scenarios by conducting a comprehensive clinical evaluation of nusinersen. Based on the method of multi-criteria decision analysis, a comprehensive clinical evaluation index system of nusinersen was established. This system, including core criterion model and contextualized criterion model, covered multiple evaluation dimensions such as safety, effectiveness, economy, and social attributes. The evidence of nusinersen in various criteria was summarized and integrated through systematic reviews. Then, different stakeholders were assigned weights and scores in various criteria of the core criterion model. Finally, a holistic value of nusinersen was estimatedthrough standardizing and combining the results in contextualized criterion model. The criteria, type of therapeutic benefit disease severity (0.08±0.02), unmet needs (0.08±0.01), quality of evidence (0.08±0.01), effectiveness (0.08±0.01) and safety (0.08±0.02) received the greatest weights after standardization. The higher mean scores for nusinersen versus placebo for the treatment of spinal muscular atrophy were disease severity (4.8±0.4), innovation of the drug (4.7±0.6), expert consensus or clinical practice guidelines (4.5±0.6), effectiveness (4.0±1.0) and quality of evidence (4.0±0.8).The holistic value of nusinersen was 0.41. The overall impact of the contextualized model on the evaluation of the drug was 0.26, indicating that it may overestimate the comprehensive value of nusinersen. The method of multi-criteria decision analysis proves the positive role that nusinersen plays in spinal muscular atrophy treatment.