Health Economics and Decision Science, School of Health and Related Research, University of Sheffield Regent Court, Court, 30 Regent Street, Sheffield, UK S1 4DA.
Osteoporos Int. 2009 Jun;20(6):853-68. doi: 10.1007/s00198-009-0844-y. Epub 2009 Mar 7.
An important component of cost effectiveness models in the field of osteoporosis is the set of Health State Utility Values (HSUVs) used for key fracture outcomes. This paper presents a review of HSUVs for key osteoporotic states (hip, wrist, shoulder, clinical, and morphometric vertebral fractures, established osteoporosis, and interaction of several fractures). It provides an update to the systematic review conducted by Brazier et al. (Osteoporos Int 13(10):768-776, 2002).
A systematic search was undertaken of the main literature databases for HSUVs for established osteoporosis, vertebral, hip, wrist, and shoulder fractures were identified. Studies meeting the inclusion criteria were reviewed in terms of the patient population, the method of describing health (if not obtained directly from patients), the method of valuing health states and the source of values.
Estimates of Health State Utility Values were found across the osteoporosis conditions from 27 studies. A wide range of empirical estimates were found, partly due to differences in valuation technique (VAS, SG, TTO), descriptive system and differences in respondents (population or patient), the perspective of the task (own health or a scenario), sample size, and study quality.
The paper provides a set of multipliers representing the loss in HSUVs for use as a "reference case" in cost-effectiveness models.
骨质疏松症领域成本效益模型的一个重要组成部分是用于关键骨折结局的一组健康状态效用值(HSUVs)。本文回顾了关键骨质疏松症状态(髋部、腕部、肩部、临床和形态计量性椎体骨折、已确诊骨质疏松症以及多种骨折的相互作用)的 HSUVs。它对 Brazier 等人进行的系统评价(Osteoporos Int 13(10):768-776, 2002)进行了更新。
对主要文献数据库进行了系统搜索,以确定已确诊骨质疏松症、椎体、髋部、腕部和肩部骨折的 HSUVs。对符合纳入标准的研究进行了回顾,内容包括患者人群、健康描述方法(如果不是直接从患者处获得)、健康状态评估方法以及价值来源。
从 27 项研究中发现了骨质疏松症各阶段的健康状态效用值估计值。由于估值技术(VAS、SG、TTO)、描述系统和受访者(人群或患者)、任务视角(自身健康或情景)、样本量和研究质量的差异,发现了广泛的经验估计值。
本文提供了一组代表 HSUV 损失的乘数,可作为成本效益模型中的“参考案例”。