关于指导前列腺癌男性管理决策的决策辅助工具的成本效益的证据有限。我们比较了导航在线决策援助对前列腺癌男性患者与常规护理（无决策援助）的成本效用。从政府医疗保健的角度构建了 10 年时间范围的马尔可夫模型。来自 Navigate 试验 (n = 302) 和相关已发表研究的数据用于模型输入。计算了这两种策略的增量成本和质量调整生命年（QALY）。采用单向和概率敏感性分析来解决模型的不确定性。平均而言，导航策略估计成本为 AU$8899（95% 不确定性区间 [UI] AU$7509-AU$10438）并产生 7.08 QALY（95% UI 6.73- 7.36) 与 AU$9559 (95% UI AU$8177-AU$11017) 和 7.03 QALY (95% UI 6.67-7.31) 或常规护理相比。导航策略在常规护理中占主导地位，因为它节省了成本并提高了 QALY，尽管这两种结果在 10 年内的差异很小。在通常可接受的每 QALY 收益 50000 澳元的阈值下，Navigate 实现成本效益的可能性为 99.7%。这项研究受到模型中使用的数据的可用性、质量和选择的限制。在澳大利亚，由于接受度和采用率较高，对前列腺癌男性使用在线决策辅助似乎比常规护理更具成本效益的主动监视。更广泛地实施决策辅助工具可以更好地告知被诊断患有前列腺癌的男性他们的治疗选择。我们研究了在线决策辅助工具的成本效益，以指导澳大利亚患有前列腺癌的男性选择治疗选择。我们发现这种决策援助具有成本效益，主要是因为更多的男性选择主动监测。告知患者其管理选择的决策辅助工具应更广泛地应用于医疗保健领域。版权所有 © 2024 欧洲泌尿外科协会。由 Elsevier B.V. 出版。保留所有权利。

Evidence on the cost effectiveness of decision aids to guide management decisions for men with prostate cancer is limited. We examined the cost utility of the Navigate online decision aid for men with prostate cancer in comparison to usual care (no decision aid).A Markov model with a 10-yr time horizon was constructed from a government health care perspective. Data from the Navigate trial (n = 302) and relevant published studies were used for model inputs. Incremental costs and quality-adjusted life-years (QALYs) were calculated for the two strategies. One-way and probabilistic sensitivity analyses were undertaken to address model uncertainty.On average, the Navigate strategy was estimated to cost AU$8899 (95% uncertainty interval [UI] AU$7509-AU$10438) and produce 7.08 QALYs (95% UI 6.73-7.36) in comparison to AU$9559 (95% UI AU$8177-AU$11017) and 7.03 QALYs (95% UI 6.67-7.31) or usual care. The Navigate strategy dominated usual care as it produced cost-savings and higher QALYs, although differences for both outcomes were small over 10 yr. The likelihood of Navigate being cost effective at a conventionally acceptable threshold of AU$50000 per QALY gained was 99.7%. This study is limited by the availability, quality, and choice of the data used in the model.Use of an online decision aid for men with prostate cancer appears to be cost effective relative to usual care in Australia, driven by the higher acceptance and uptake of active surveillance. Wider implementation of decision aids may better inform men diagnosed with prostate cancer about their management options.We looked at the cost effectiveness of an online decision aid for guiding Australian men with prostate cancer in choosing a management option. We found that this decision aid was cost effective, mainly because more men chose active surveillance. Decision aids that inform patients about their management options should be more widely used in health care.Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.