BACKGROUND Depressed patients often focus on negative life events. Effective antidepressant therapy reverses this negative emotional bias (NEB) within 1 week. Clinical therapeutic effect usually requires 4-6 weeks. The value of implementing NEB monitoring for the personalisation of antidepressant therapy is unknown. OBJECTIVE To estimate the likely outcome and cost consequences of adopting the P1vital Oxford Emotional Test Battery (ETB) for this purpose in routine primary care in England. METHODS A hybrid decision analytic model (decision tree plus Markov model) was developed to estimate the cost-effectiveness of ETB monitoring versus no ETB over 52 weeks using quality-adjusted life years (QALYs). Differences in depression severity, episode type and analytical perspectives were considered. Input data were derived from relevant guidelines, literature, national databases, expert opinion and the developers for the year 2013. Multiple sensitivity analyses addressed uncertainty. FINDINGS The mean number of ETB tests is 2.162 per newly diagnosed patient and 2.166 per patient with recurrent depression. The incremental cost-effectiveness of ETB versus 'no ETB' is £4355/QALY from the healthcare perspective. From the broader societal perspective, ETB is more effective and cost saving. CONCLUSIONS Monitoring negative emotional bias in primary care in England for personalised antidepressant treatment using ETB seems as an effective and cost-effective option under all considered scenarios (including worst case). Its main economic value seems to lie in reduced productivity loss as opposed to healthcare savings. CLINICAL IMPLICATIONS The test supports accelerated application of evidence-based depression care. Further optimisation and implementation in the ongoing European PReDicT trial is ongoing.

中文翻译：

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监测英国初级保健中的负面情绪偏见对于个性化抗抑郁治疗的价值：一项建模研究。

背景技术抑郁症患者常常关注消极的生活事件。有效的抗抑郁治疗可在 1 周内扭转这种负面情绪偏见 (NEB)。临床治疗效果通常需要4-6周。实施 NEB 监测对于抗抑郁治疗个体化的价值尚不清楚。目的 评估英格兰常规初级保健中为此目的采用 P1vital 牛津情绪测试套件 (ETB) 的可能结果和成本后果。方法 开发了混合决策分析模型（决策树加马尔可夫模型），以使用质量调整生命年 (QALY) 来评估 52 周内 ETB 监测与无 ETB 的成本效益。考虑了抑郁症严重程度、发作类型和分析观点的差异。输入数据来自 2013 年的相关指南、文献、国家数据库、专家意见和开发人员。多重敏感性分析解决了不确定性。结果 每名新诊断患者接受 ETB 测试的平均次数为 2.162 次，每位复发性抑郁症患者接受 2.166 次 ETB 测试。从医疗保健角度来看，ETB 与“无 ETB”相比的增量成本效益为 4355 英镑/QALY。从更广泛的社会角度来看，ETB 更有效、更节省成本。结论 在所有考虑的情况下（包括最坏的情况），在英格兰初级保健中监测负面情绪偏见，以使用 ETB 进行个性化抗抑郁治疗似乎是一种有效且具有成本效益的选择。其主要经济价值似乎在于减少生产力损失，而不是节省医疗费用。临床意义 该测试支持加速应用循证抑郁症护理。正在进行的欧洲 PREDicT 试验正在进行进一步优化和实施。