目的:在成本效用分析文献中描述健康状态效用值的特征和来源以及报告实践,有助于理解透明度水平,有效性,和成本效用分析的概括性。提高报告质量将支持研究人员描述新出现的青光眼干预措施的增量价值。
目的:描述已发表的青光眼成本-效用分析研究的实践状态,侧重于健康评估和报告质量。
方法:我们搜索了几个数据库,包括Medline,CINHAL,Embase,WebofScience,Scopus,Biosispreviews,卫生经济评价数据库,和NHS经济评估数据库(NHSEED)。我们包括全文,英语,已发表的以质量调整生命年(QALYs)为主要结局指标的青光眼干预措施成本-效用分析,以计算增量成本-效用比.排除的研究是非英语语言,reviews,社论,协议,或其他类型的经济研究(成本效益,成本最小化,成本效益)。研究特点,提取了青光眼健康状态和健康状态实用程序的操作定义。对健康效用的原始来源进行了审查,以确定测量的规模和偏好权重的来源。使用成本效益系统评价(SpRUCE检查表)中的项目来评估青光眼CUA中卫生实用程序的报告和质量。
结果:包括43个CUA,拥有11种独特的卫生公用事业来源。据报道,针对相同的Hodapp-Parrish-Anderson青光眼健康状态的各种健康实用程序;高眼压(0.84-0.95),轻度(0.68-0.94),中等(0.57-0.92),先进(0.58-0.88),严重/失明(0.46-0.76),和双侧失明(0.26-0.5)。大多数研究报告了使用卫生公用事业的基础(34,79%)以及适用于卫生公用事业的任何假设或调整(22,51%)。很少有研究报告了评估卫生公用事业与决策背景相关性的框架(8,19%)。更少的人(3,7%)采用系统的搜索策略来识别卫生实用程序,并使用结构化的质量评估进行纳入。总的来说,报告没有随着时间的推移而改善。
结论:这篇综述描述了很少有CIA描述使用健康状态效用值的重要理由。包括搜索的其他细节,评估,选择,健康效用值的纳入过程提高了透明度,概括性,支持对研究结论有效性的评估。未来的调查应旨在在健康状态之间以相同的测量规模使用健康实用程序,并考虑进行成本效用研究的决策背景/目的的来源和相关性。
OBJECTIVE: Describing the characteristics and sources of health state utility values and reporting practice in the literature of cost-utility analyses facilitates an understanding of the level of the transparency, validity, and generalizability of cost-utility analyses. Improving the quality of reporting will support investigators in describing the incremental value of emerging glaucoma interventions.
OBJECTIVE: To describe the state of practice among published glaucoma cost-utility analysis studies, focusing on valuation of health and the quality of reporting.
METHODS: We searched several databases including Medline, CINHAL, Embase, Web of Science, Scopus, Biosis previews, the Health Economic Evaluations Database, and the NHS Economic Evaluation Database (NHS EED). We included full-text, English, published cost-utility analyses of glaucoma interventions with quality-adjusted life years (QALYs) as the primary outcome measure to calculate incremental cost-utility ratios. Excluded studies were non-English language, reviews, editorials, protocols, or other types of economic studies (cost-benefit, cost-minimization, cost-effectiveness). Study characteristics, operational definitions of glaucoma health states and health state utilities were extracted. The original source of the health utility was reviewed to determine the scale of measurement and the source of preference weighting. Items from the Systematic
Review of Utilities for Cost-Effectiveness (SpRUCE checklist) were used to assess the reporting and quality of health utilities in glaucoma CUA.
RESULTS: 43 CUAs were included, with 11 unique sources of health utilities. A wide range of health utilities for the same Hodapp-Parrish-Anderson glaucoma health states were reported; ocular hypertension (0.84-0.95), mild (0.68-0.94), moderate (0.57-0.92), advanced (0.58-0.88), severe/blind (0.46-0.76), and bilateral blindness (0.26-0.5). Most studies reported the basis for using health utilities (34, 79%) and any assumptions or adjustments applied to the health utilities (22, 51%). Few studies reported a framework for assessing the relevance of health utilities to a decision context (8, 19%). Even fewer (3, 7%) applied a systematic search strategy to identify health utilities and used a structured assessment of quality for inclusion. Overall, reporting has not improved over time.
CONCLUSIONS: This
review describes that few CUAs describe important rationale for using health state utility values. Including additional details on the search, appraisal, selection, and inclusion process of health utility values improves transparency, generalizability and supports the assessment of the validity of study conclusions. Future investigations should aim to use health utilities on the same scale of measurement across health states and consider the source and relevance to the decision context/purpose of conducting that cost-utility study.