Programs for Assessment of Technology in Health (PATH) Research Institute, St Joseph's Healthcare Hamilton, Ontario, Canada.
Health Qual Life Outcomes. 2010 Jan 27;8:12. doi: 10.1186/1477-7525-8-12.
Cost-utility analyses are commonly used in economic evaluations of interventions or conditions that have an impact on health-related quality of life. However, evaluating utilities in children presents several challenges since young children may not have the cognitive ability to complete measurement tasks and thus utility values must be estimated by proxy assessors. Another solution is to use utilities derived from an adult population. To better inform the future conduct of cost-utility analyses in paediatric populations, we reviewed the published literature reporting utilities among children and adults across selected conditions common to paediatric and adult populations.
An electronic search of Ovid MEDLINE, EMBASE, and the Cochrane Library up to November 2008 was conducted to identify studies presenting utility values derived from the Health Utilities Index (HUI) or EuroQoL-5Dimensions (EQ-5D) questionnaires or using time trade off (TTO) or standard gamble (SG) techniques in children and/or adult populations from randomized controlled trials, comparative or non-comparative observational studies, or cross-sectional studies. The search was targeted to four chronic diseases/conditions common to both children and adults and known to have a negative impact on health-related quality of life (HRQoL).
After screening 951 citations identified from the literature search, 77 unique studies included in our review evaluated utilities in patients with asthma (n = 25), cancer (n = 23), diabetes mellitus (n = 11), skin diseases (n = 19) or chronic diseases (n = 2), with some studies evaluating multiple conditions. Utility values were estimated using HUI (n = 33), EQ-5D (n = 26), TTO (n = 12), and SG (n = 14), with some studies applying more than one technique to estimate utility values. 21% of studies evaluated utilities in children, of those the majority being in the area of oncology. No utility values for children were reported in skin diseases. Although few studies provided comparative information on utility values between children and adults, results seem to indicate that utilities may be similar in adolescents and young adults with asthma and acne. Differences in results were observed depending on methods and proxies.
This review highlights the need to conduct future research regarding measurement of utilities in children.
成本效用分析常用于评估对健康相关生活质量有影响的干预措施或情况。然而，评估儿童的效用值存在一些挑战，因为年幼的儿童可能没有认知能力来完成测量任务，因此必须由代理评估者来估计效用值。另一种解决方案是使用来自成人人群的数据来推导效用值。为了更好地为未来在儿科人群中进行成本效用分析提供信息，我们对报告了在儿科和成人人群中常见的特定疾病中儿童和成人的效用值的已发表文献进行了综述。
我们对 Ovid MEDLINE、EMBASE 和 Cochrane 图书馆进行了电子检索，检索时间截至 2008 年 11 月，以确定在随机对照试验、比较或非比较观察性研究或横断面研究中，使用健康效用指数（HUI）或欧洲五维健康量表（EQ-5D）问卷或时间权衡（TTO）或标准博弈（SG）技术，报告儿童和/或成人人群的效用值的研究。检索的目标是针对四种在儿童和成人中都常见且已知对健康相关生活质量（HRQoL）有负面影响的慢性疾病/状况。
在对文献检索中确定的 951 篇引文进行筛选后，我们对 77 项独特的研究进行了综述，这些研究评估了哮喘（n = 25）、癌症（n = 23）、糖尿病（n = 11）、皮肤病（n = 19）或慢性疾病（n = 2）患者的效用值，一些研究评估了多种疾病。使用 HUI（n = 33）、EQ-5D（n = 26）、TTO（n = 12）和 SG（n = 14）来估计效用值，一些研究应用了一种以上的技术来估计效用值。21%的研究评估了儿童的效用值，其中大多数是在肿瘤学领域。皮肤病领域没有报告儿童的效用值。尽管少数研究提供了儿童和成人之间的效用值比较信息，但结果似乎表明，哮喘和痤疮青少年和年轻成人的效用值可能相似。结果的差异取决于方法和代理。
本综述强调了需要对儿童的效用值测量进行未来研究。
