决策树-马尔可夫模型在心房颤动筛查经济学评价中的应用

心房颤动（简称房颤）近年来的发病率呈现年轻化趋势，严重威胁着人类的生存及健康。基于决策树?马尔可夫模型，模拟房颤?脑卒中?疾病转归的自然发展过程，依据成本效用等指标开展不同房颤筛查策略的卫生经济学评价。针对上海地区和国内平均水平分别提出了不同的最优筛查组合策略。通过模型敏感性分析发现，房颤筛查费用对于上海的成本效用敏感性最强，而抗凝治疗费用对于国内平均的成本效用敏感性最强。最后，为了更好地开展针对房颤的健康管理，给出了房颤筛查策略的建议，为我国房颤筛查防治的健康管理模式优化提供参考。

Application of decision tree-Markov model in economic evaluation of atrial fibrillation screening

The incidence of atrial fibrillation (AF) has been younger in recent years and AF seriously threatens human survival and health. Based on the decision tree-Markov model, the natural development process of AF-stroke-disease outcome was simulated, and the health economics evaluation of different atrial fibrillation screening strategies was carried out according to the indicators of cost and utility. Different optimal screening combination strategies were proposed according to the level in Shanghai and domestic average. Further sensitivity analysis indicated that the cost-effectiveness sensitivity of AF screening cost was the most significant in Shanghai, but the cost of anticoagulant treatment was the most sensitive to the cost utility of the domestic average. Finally, in order to better carry out health management of AF, some suggestions on AF screening strategies were put forward, which provided a reference for the optimization of health management mode of AF screening and prevention in our country.