scholarly journals Health state utility values by cancer stage: a systematic literature review

2021 ◽  
Author(s):  
Mir-Masoud Pourrahmat ◽  
Ashley Kim ◽  
Anuraag R. Kansal ◽  
Marg Hux ◽  
Divya Pushkarna ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Stage Iv ◽  
Health State ◽  
Cancer Type ◽  
Cancer Stage ◽  
Utility Values ◽  
Cancer Types ◽  
Health State Utility Values

Abstract Objectives Cancer diagnoses at later stages are associated with a decrease in health-related quality of life (HRQOL). Health state utility values (HSUVs) reflect preference-based HRQOL and can vary based on cancer type, stage, treatment, and disease progression. Detecting and treating cancer at earlier stages may lead to improved HRQOL, which is important for value assessments. We describe published HSUVs by cancer type and stage. Methods A systematic review was conducted using Embase, MEDLINE®, EconLit, and gray literature to identify studies published from January 1999 to September 2019 that reported HSUVs by cancer type and stage. Disutility values were calculated from differences in reported HSUVs across cancer stages. Results From 13,872 publications, 27 were eligible for evidence synthesis. The most frequent cancer types were breast (n = 9), lung (n = 5), colorectal (n = 4), and cervical cancer (n = 3). Mean HSUVs decreased with increased cancer stage, with consistently lower values seen in stage IV or later-stage cancer across studies (e.g., − 0.74, − 0.44, and − 0.51 for breast, colorectal, and cervical cancer, respectively). Disutility values were highest between later-stage (metastatic or stage IV) cancers compared to earlier-stage (localized or stage I–III) cancers. Conclusions This study provides a summary of HSUVs across different cancer types and stages that can inform economic evaluations. Despite the large variation in HSUVs overall, a consistent decline in HSUVs can be seen in the later stages, including stage IV. These findings indicate substantial impairment on individuals’ quality of life and suggest value in early detection and intervention.

scholarly journals Health state utility values in people living with HTLV-1 and in patients with HAM/TSP: The impact of a neglected disease on the quality of life

2020 ◽  
Vol 14 (10) ◽  
pp. e0008761
Author(s):  
Carolina Rosadas ◽  
Tatiane Assone ◽  
Marina Yamashita ◽  
Adine Adonis ◽  
Marzia Puccioni-Sohler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health State Utility ◽  
Health State ◽  
Neglected Disease ◽  
Utility Values ◽  
Health State Utility Values ◽  
The Impact

scholarly journals Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study

2019 ◽  
Author(s):  
Austyn Snowden ◽  
Jenny Young ◽  
Jan Savinc
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Health Status ◽  
Cancer Type ◽  
Cancer Stage ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Abstract Background Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention. Method Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, approximately 4 months later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models. Results Participants were White British with median age between 50-64 years. Cancer type and stage were varied. There was a statistically significant improvement in EQ-5D scores over time (t(330)=7.48, p<.001). The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants has a statistically and meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants this study has reported that it is possible to capture a meaningful improvement as a function of reducing someone’s personally identified concerns.

scholarly journals PCN309 HEALTH STATE UTILITY VALUES ACROSS CANCER TYPES AND STAGES: A SYSTEMATIC LITERATURE REVIEW

2020 ◽  
Vol 23 ◽  
pp. S78
Author(s):  
M.M. Pourrahmat ◽  
A.R. Kansal ◽  
K.C. Chung ◽  
M. Hux ◽  
A. Howarth ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Health State Utility ◽  
Health State ◽  
Utility Values ◽  
Cancer Types ◽  
Health State Utility Values

VP133 Patient-Reported Health State Utilities In Neuroendocrine Tumours

2017 ◽  
Vol 33 (S1) ◽  
pp. 210-210
Author(s):  
Yang Meng ◽  
Grant McCarthy ◽  
Anthony Berthon ◽  
Jerome Dinet
Keyword(s):  
Quality Of Life ◽  
Progressive Disease ◽  
Neuroendocrine Tumours ◽  
Disease State ◽  
Health State ◽  
Utility Values ◽  
Patient Reported ◽  
Health State Utilities ◽  
Reported Health

INTRODUCTION:Gastroenteropancreatic neuroendocrine tumours (GEP-NETs) are rare cancers most often found in the gastrointestinal system or the pancreas. However, patient-reported health state utilities based on clinical trials have not been previously reported in this disease area.METHODS:The CLARINET study collected the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 data from patients in both stable and progressive disease states, although data for the latter were only available during the early stage of progression due to trial design. Using published algorithms, data were mapped to EQ-5D utility values. Random-effects generalized least squares models were used to investigate the impacts of progression status, tumour site and other patient characteristics on mapped utility values.RESULTS:In total, 1,053 observations from 204 patients were mapped to EuroQol (EQ-5D) utilities using the McKenzie mapping algorithm. The final random-effects model included age, gender, baseline utility and progression status as covariates; it was not feasible to investigate time-to-death utility due to a limited number of death in the CLARINET study. Tumour location (midgut versus pancreas) does not seem to affect utility. However, the difference in utilities based on progression status is statistically significant (p<.05) in the base case analysis, and the estimated utilities for stable and progressive disease are .776 and .726, respectively. Furthermore, scenario analyses showed that utility for progressive disease is numerically lower than for stable disease, but this may not be statistically significant in some scenarios.CONCLUSIONS:Patients with GEP-NETs experience worse utility values in the progressive disease state compared to the stable disease state, based on patient-reported health-related quality of life (HRQL) data from the CLARINET study. The decline of utility in the progressive disease state may be underestimated because progressive HRQL data were only collected shortly after the progression event in the trial. The estimated trial-based utilities can be used in future economic evaluations for GEP-NET treatments and to provide more insights to physicians on patient-reported quality of life outcomes in GEP-NETs.

Health state utility values in schizophrenia: protocol for a systematic review and meta-analysis

2019 ◽  
Vol 22 (4) ◽  
pp. 142-144 ◽  
Author(s):  
David Aceituno ◽  
Mark Pennington ◽  
Barbara Iruretagoyena ◽  
Matthew A Prina ◽  
Paul McCrone
Keyword(s):  
Systematic Review ◽  
Task Force ◽  
Meta Analysis ◽  
Cost Effective ◽  
Health State Utility ◽  
Health State ◽  
Utility Values ◽  
Life Years ◽  
Health State Utility Values

IntroductionCost-effectiveness analyses that use quality-adjusted life-years (QALYs) allow comparing the value for money of interventions across different health problems. Health state utility values (HSUVs) are crucial to calculate QALYs. These are weights attached to a given health state reflecting preferences in health-related quality of life (HRQoL). In schizophrenia, there is extensive evidence about the consequences of this condition on HRQoL. Besides, several interventions have claimed to be cost-effective in terms of QALYs gained. Despite this evidence, a systematic review of HSUVs has not been conducted. Therefore, we aim to synthesise the evidence about HSUVs in schizophrenia.Methods and analysisWe will conduct a systematic review of the literature about HSUVs in people with schizophrenia following the Preferred Reporting Items for Systematic review and Meta-Analysis and the International Society for Pharmacoeconomics and Outcomes Research task force recommendations. The submissions records of eight electronic peer-reviewed databases and three health technology assessment (HTA) agencies will be searched. Quantitative synthesis will be carried out in comparable studies, using random-effects meta-analysis. Heterogeneity will be explored using meta-regression if more than 10 studies per covariate are found. A narrative synthesis and methodological quality of included studies will be also reported.DiscussionThis review will provide a synthesis of the HSUVs estimated for different states experienced by people with schizophrenia. This will inform analysts when calculating QALYs, using values in a more transparent and accountable manner. Finally, it will shed light on evidence gaps and limitations about this measure in mental health.PROSPERO registration numberCRD42019123582.

scholarly journals Estimation of Health-State Utility Values and Factors Driving Health-Related Quality of Life in People Living with HIV and AIDS and Receiving cART in Germany: Baseline Analysis of a Cohort Study

2021 ◽  
Author(s):  
Martina Treskova ◽  
Stefan Scholz ◽  
Alexander Kuhlmann ◽  
Jörg Mahlich ◽  
Matthias Stoll
Keyword(s):  
Quality Of Life ◽  
Patient Characteristics ◽  
Hiv And Aids ◽  
People Living With Hiv ◽  
Health State ◽  
Utility Values ◽  
Health State Utilities ◽  
Living With Hiv ◽  
Eq Vas

AbstractHIV has become a chronic disease since widespread of combined antiretroviral therapy (cART). Understanding the influence of therapeutic and preventive interventions on health-related quality of life (HRQoL) of people living with HIV and AIDS (PLWHA) is important. Information about health state utilities and HRQoL in PLWHA after the introduction of cART is limited, especially in Germany. The study aims to estimate and describe health state utilities and HRQoL in PLWHA in Germany and explore the effects of patient characteristics, clinical and treatment factors. Utilities and HRQoL in PLWHA in Germany were measured with the generic EQ-5D-3L questionnaire. Health state utilities were calculated based on the EQ-5D descriptive system using the German EQ-5D-3L time trade-off (TTO) value set. HRQoL was calculated based on the EQ visual analogue scale (EQ-VAS). Extensive descriptive analyses were performed to represent utility values for different groups of the patients. Generalized linear models (GLMs) with beta-inflated distributions were used to determine patient characteristics and clinical factors that influence TTO utilities and VAS scores. 1056 PLWHA completed the EQ-5D-3L questionnaires at the beginning of the study. The mean TTO utility value is 0.912 (SD ± 0.154), and the mean VAS HRQoL is 84.32 (SD ± 18.55). “Anxiety/depression” and “pain/physical discomfort” are the most affected dimensions. A longer period of living with HIV, a lower CD4-cell count, having symptomatic HIV or AIDS and an increased number of changes in therapy are associated with decreased utilities and a lower probability of having HRQoL of perfect health. No significant effect of duration of regimen was found. Depression significantly decreases TTO utility values. Higher education, full-time employment and female gender are associated with higher utilities. The resulted EQ-VAS values for PLWHA in Germany are comparable with EQ-VAS estimates for the general population. The obtained estimates can be used as inputs for health economic evaluations of HIV-interventions. Addressing anxiety and depression may reduce the quality of life impairment in PLWHA. Impact of comorbidities needs further investigation.

scholarly journals Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study 

2020 ◽  
Author(s):  
Austyn Snowden ◽  
Jenny Young ◽  
Jan Savinc
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Health Status ◽  
Cancer Type ◽  
Cancer Stage ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background: Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention.Method: Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, median 84 days later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models with heteroscedasticity-consistent standard errors. Results: Participants were White British with median age between 50-64 years. Cancer type and stage were varied. EQ-5D utility scores improved at follow-up by 0.121 [0.0891-0.153], p<.001, and VAS scores improved by 7.81 [5.88-9.74], p<.001. The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion: This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants had both a statistically significant and clinically meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants, this study has shown for the first time that it is possible to capture a clinically meaningful improvement as a function of reducing someone’s personally identified concerns.

Deficits in preference-based health-related quality of life after complications associated with tibial fracture

2018 ◽  
Vol 100-B (9) ◽  
pp. 1227-1233 ◽  
Author(s):  
I. L. Gitajn ◽  
A. J. Titus ◽  
A. N. Tosteson ◽  
S. Sprague ◽  
K. Jeray ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Tibial Fracture ◽  
Short Form ◽  
Tibial Fractures ◽  
Health State ◽  
Life Years ◽  
Related Quality ◽  
Health Related ◽  
Health State Utility Values

Aims The aims of this study were to quantify health state utility values (HSUVs) after a tibial fracture, investigate the effect of complications, to determine the trajectory in HSUVs that result in these differences and to quantify the quality-adjusted life years (QALYs) experienced by patients. Patients and Methods This is an analysis of 2138 tibial fractures enrolled in the Fluid Lavage of Open Wounds (FLOW) and Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT) trials. Patients returned for follow-up at two and six weeks and three, six, nine and 12 months. Short-Form Six-Dimension (SF-6D) values were calculated and used to calculate QALYs. Results Compared with those who did not have a complication, those with a complication treated either nonoperatively or operatively had lower HSUVs at all times after two weeks. The HSUVs improved in all patients with the passage of time. However, they did not return to the remembered baseline preinjury values nor to US age-adjusted normal values by 12 months after the injury. Conclusion While the acute fracture and complications may have resolved clinically, the detrimental effect on a patient’s quality of life persists up to 12 months after the injury. Cite this article: Bone Joint J 2018;100-B:1227–33.

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