Abstract：
OBJECTIVE: Streptococcus pneumoniae infections remain a significant source of morbidity and mortality worldwide. The purpose of this review was to summarize the impact of pneumococcal disease on health state utilities (HSU) in the acute phase of illness.
METHODS: We searched MEDLINE, EMBASE, EconLit, the Health Technology Assessment Database, the National Health Economic Evaluation Database, and Tufts Cost-Effectiveness Registry (up to January 2020) for primary studies. Eligible studies elicited HSU estimates using preference-based instruments for the acute phase of infection of pneumococcal syndromes including acute otitis media, pneumonia/lower respiratory tract infections, bacteremia/sepsis, and meningitis. Two reviewers independently conducted screening, data extraction and quality appraisal.
RESULTS: We screened 10,178 studies, of which 26 met our inclusion criteria. Cohort sizes ranged from 8 to 2060 respondents. The most frequently studied syndrome was pneumonia (n = 17), followed by acute otitis media (n = 9), meningitis (n = 7) and bacteremia/sepsis (n = 4). Overall, each syndrome was associated with a substantial impact on HSU. Bacteremia/sepsis (range: - 0.331 to 0.992) and meningitis (range: - 0.330 to 0.977) were generally associated with the lowest HSU, followed by pneumonia (range: - 0.054 to 0.998) and acute otitis media (range: 0.064 to 0.970). HSU estimates varied considerably by treatment setting, elicitation method and type of respondent. The only study to compare pneumococcal infections to non-pneumococcal infections in the same population revealed significantly lower HSU estimates among pneumococcal infections.
CONCLUSIONS: Pneumococcal syndromes are associated with decreased HSU estimates. Given the considerable heterogeneity in methods and source populations as well as study quality, care should be taken to select the most appropriate estimates.
METHODS: We searched MEDLINE, EMBASE, EconLit, the Health Technology Assessment Database, the National Health Economic Evaluation Database, and Tufts Cost-Effectiveness Registry (up to January 2020) for primary studies. Eligible studies elicited HSU estimates using preference-based instruments for the acute phase of infection of pneumococcal syndromes including acute otitis media, pneumonia/lower respiratory tract infections, bacteremia/sepsis, and meningitis. Two reviewers independently conducted screening, data extraction and quality appraisal.
RESULTS: We screened 10,178 studies, of which 26 met our inclusion criteria. Cohort sizes ranged from 8 to 2060 respondents. The most frequently studied syndrome was pneumonia (n = 17), followed by acute otitis media (n = 9), meningitis (n = 7) and bacteremia/sepsis (n = 4). Overall, each syndrome was associated with a substantial impact on HSU. Bacteremia/sepsis (range: - 0.331 to 0.992) and meningitis (range: - 0.330 to 0.977) were generally associated with the lowest HSU, followed by pneumonia (range: - 0.054 to 0.998) and acute otitis media (range: 0.064 to 0.970). HSU estimates varied considerably by treatment setting, elicitation method and type of respondent. The only study to compare pneumococcal infections to non-pneumococcal infections in the same population revealed significantly lower HSU estimates among pneumococcal infections.
CONCLUSIONS: Pneumococcal syndromes are associated with decreased HSU estimates. Given the considerable heterogeneity in methods and source populations as well as study quality, care should be taken to select the most appropriate estimates.
摘要：
目的：肺炎链球菌感染仍然是全球发病率和死亡率的重要来源。这篇综述的目的是总结肺炎球菌疾病对疾病急性期健康状态公用事业（HSU）的影响。
方法：我们搜索了MEDLINE，EMBASE,EconLit,卫生技术评估数据库，国家卫生经济评价数据库，和塔夫茨成本效益登记处(截至2020年1月)进行初步研究。符合条件的研究使用基于偏好的仪器对包括急性中耳炎在内的肺炎球菌综合征感染的急性期进行了HSU估计。肺炎/下呼吸道感染，菌血症/败血症,和脑膜炎。两名评审员独立进行筛选，数据提取和质量评价。
结果：我们筛选了10,178项研究，其中26人符合我们的入选标准。队列大小从8到2060个受访者不等。最常见的研究综合征是肺炎（n=17），其次是急性中耳炎（n=9），脑膜炎（n=7）和菌血症/败血症（n=4）。总的来说,每种综合征均对HSU产生实质性影响.菌血症/败血症（范围：-0.331至0.992）和脑膜炎（范围：-0.330至0.977）通常与最低HSU相关，其次是肺炎（范围：-0.054至0.998）和急性中耳炎（范围：0.064至0.970）。HSU的估计值因治疗环境而异，启发方法和受访者类型。唯一一项在同一人群中比较肺炎球菌感染与非肺炎球菌感染的研究显示，肺炎球菌感染中的HSU估计值明显较低。
结论：肺炎球菌综合征与HSU估计值降低相关。鉴于方法和来源人群以及研究质量的相当大的异质性，应该注意选择最合适的估计。
方法：我们搜索了MEDLINE，EMBASE,EconLit,卫生技术评估数据库，国家卫生经济评价数据库，和塔夫茨成本效益登记处(截至2020年1月)进行初步研究。符合条件的研究使用基于偏好的仪器对包括急性中耳炎在内的肺炎球菌综合征感染的急性期进行了HSU估计。肺炎/下呼吸道感染，菌血症/败血症,和脑膜炎。两名评审员独立进行筛选，数据提取和质量评价。
结果：我们筛选了10,178项研究，其中26人符合我们的入选标准。队列大小从8到2060个受访者不等。最常见的研究综合征是肺炎（n=17），其次是急性中耳炎（n=9），脑膜炎（n=7）和菌血症/败血症（n=4）。总的来说,每种综合征均对HSU产生实质性影响.菌血症/败血症（范围：-0.331至0.992）和脑膜炎（范围：-0.330至0.977）通常与最低HSU相关，其次是肺炎（范围：-0.054至0.998）和急性中耳炎（范围：0.064至0.970）。HSU的估计值因治疗环境而异，启发方法和受访者类型。唯一一项在同一人群中比较肺炎球菌感染与非肺炎球菌感染的研究显示，肺炎球菌感染中的HSU估计值明显较低。
结论：肺炎球菌综合征与HSU估计值降低相关。鉴于方法和来源人群以及研究质量的相当大的异质性，应该注意选择最合适的估计。
