PDF(Pubmed)
Abstract：
BACKGROUND: As disease-modifying Alzheimer\'s (AD) treatments are becoming available, concerns have been raised that even high-income countries lack the diagnostic capacity to accurately identify eligible patients in a timely manner.
OBJECTIVE: We analyze how much NHS England would have to invest in capacity for AD specialists, biomarker testing with PET scans or CSF testing and MRI scans to reach G7 average levels and estimate the effect on wait times in the diagnostic process.
METHODS: Desk research and expert interviews for cost and capacity data. Markov model to estimate wait times.
METHODS: NHS England.
METHODS: AD specialists, and PET and MRI scanners per capita in G7 countries and wait times in England under different investment scenarios.
RESULTS: England has the lowest number of PET and MRI scanners and the second-lowest of AD specialists per capita among the G7 countries. An investment of GBP 14 billion over ten years would be needed to reach G7 average levels, of which 31%, 22%, 10%, 37% would be devoted to capacity for memory assessment services, PET scanning, CSF analysis, and MRI scanning, respectively. This investment would reduce estimated average wait times by around 87% between 2023 and 2032.
CONCLUSIONS: The NHS England has large gaps in diagnostic capacity for AD. Without substantial investments, AD patients in England would experience substantial wait times and avoidable disease progression.
OBJECTIVE: We analyze how much NHS England would have to invest in capacity for AD specialists, biomarker testing with PET scans or CSF testing and MRI scans to reach G7 average levels and estimate the effect on wait times in the diagnostic process.
METHODS: Desk research and expert interviews for cost and capacity data. Markov model to estimate wait times.
METHODS: NHS England.
METHODS: AD specialists, and PET and MRI scanners per capita in G7 countries and wait times in England under different investment scenarios.
RESULTS: England has the lowest number of PET and MRI scanners and the second-lowest of AD specialists per capita among the G7 countries. An investment of GBP 14 billion over ten years would be needed to reach G7 average levels, of which 31%, 22%, 10%, 37% would be devoted to capacity for memory assessment services, PET scanning, CSF analysis, and MRI scanning, respectively. This investment would reduce estimated average wait times by around 87% between 2023 and 2032.
CONCLUSIONS: The NHS England has large gaps in diagnostic capacity for AD. Without substantial investments, AD patients in England would experience substantial wait times and avoidable disease progression.
摘要：
背景：随着改善阿尔茨海默病（AD）的治疗方法的出现，有人担心，即使是高收入国家也缺乏及时准确识别合格患者的诊断能力。
目的：我们分析了NHS英格兰在AD专家的能力上需要投资多少，使用PET扫描或CSF测试和MRI扫描进行生物标志物测试，以达到G7平均水平，并评估对诊断过程中等待时间的影响。
方法：成本和容量数据的案头研究和专家访谈。马尔可夫模型来估计等待时间。
方法：NHS英格兰。
方法：AD专家，G7国家的人均PET和MRI扫描仪，以及不同投资情景下英国的等待时间。
结果：在七国集团国家中，英国的PET和MRI扫描仪数量最少，人均AD专家数量排名第二。需要在十年内投资140亿英镑才能达到G7的平均水平，其中31%,22%,10%,37%将用于内存评估服务的容量，PET扫描,CSF分析，和核磁共振扫描,分别。这项投资将使2023年至2032年间的平均等待时间减少约87%。
结论：英国NHS在AD诊断能力方面存在很大差距。如果没有大量投资，英格兰的AD患者将经历大量的等待时间和可避免的疾病进展。
目的：我们分析了NHS英格兰在AD专家的能力上需要投资多少，使用PET扫描或CSF测试和MRI扫描进行生物标志物测试，以达到G7平均水平，并评估对诊断过程中等待时间的影响。
方法：成本和容量数据的案头研究和专家访谈。马尔可夫模型来估计等待时间。
方法：NHS英格兰。
方法：AD专家，G7国家的人均PET和MRI扫描仪，以及不同投资情景下英国的等待时间。
结果：在七国集团国家中，英国的PET和MRI扫描仪数量最少，人均AD专家数量排名第二。需要在十年内投资140亿英镑才能达到G7的平均水平，其中31%,22%,10%,37%将用于内存评估服务的容量，PET扫描,CSF分析，和核磁共振扫描,分别。这项投资将使2023年至2032年间的平均等待时间减少约87%。
结论：英国NHS在AD诊断能力方面存在很大差距。如果没有大量投资，英格兰的AD患者将经历大量的等待时间和可避免的疾病进展。
