Xie Feng, Kovic Bruno, Jin Xuejing, He Xiaoning, Wang Mengxiao, Silvestre Camila
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Department of Kinesiology, University of Waterloo, Waterloo, Canada.
Pharmacoeconomics. 2016 Nov;34(11):1087-1100. doi: 10.1007/s40273-016-0424-x.
Osteoarthritis (OA) consumes a significant amount of healthcare resources, and impairs the health-related quality of life (HRQoL) of patients. Previous reviews have consistently found substantial variations in the costs of OA across studies and countries. The comparability between studies was poor and limited the detection of the true differences between these studies.
To review large sample studies on measuring the economic and/or humanistic burden of OA published since May 2006.
We searched MEDLINE and EMBASE databases using comprehensive search strategies to identify studies reporting economic burden and HRQoL of OA. We included large sample studies if they had a sample size ≥1000 and measured the cost and/or HRQoL of OA. Reviewers worked independently and in duplicate, performing a cross-check between groups to verify agreement. Within- and between-group consolidation was performed to resolve discrepancies, with outstanding discrepancies being resolved by an arbitrator. The Kappa statistic was reported to assess the agreement between the reviewers. All costs were adjusted in their original currency to year 2015 using published inflation rates for the country where the study was conducted, and then converted to 2015 US dollars.
A total of 651 articles were screened by title and abstract, 94 were reviewed in full text, and 28 were included in the final review. The Kappa value was 0.794. Twenty studies reported direct costs and nine reported indirect costs. The total annual average direct costs varied from US$1442 to US$21,335, both in USA. The annual average indirect costs ranged from US$238 to US$29,935. Twelve studies measured HRQoL using various instruments. The Short Form 12 version 2 scores ranged from 35.0 to 51.3 for the physical component, and from 43.5 to 55.0 for the mental component. Health utilities varied from 0.30 for severe OA to 0.77 for mild OA.
Per-patient OA costs are considerable and a patient's quality of life remains poor. Variations in costing methods are a barrier to understanding the true differences in the costs of OA between studies. Standardizing healthcare resource items, the definition of OA-relevant costs, and productivity loss measures would facilitate the comparison.
骨关节炎（OA）消耗了大量医疗资源，并损害了患者的健康相关生活质量（HRQoL）。以往的综述一直发现，不同研究和国家之间OA的成本存在显著差异。研究之间的可比性较差，限制了对这些研究之间真正差异的检测。
回顾2006年5月以来发表的关于测量OA经济和/或人文负担的大样本研究。
我们使用全面的检索策略搜索MEDLINE和EMBASE数据库，以识别报告OA经济负担和HRQoL的研究。如果大样本研究的样本量≥1000且测量了OA的成本和/或HRQoL，我们将其纳入。评审人员独立且重复地工作，在小组之间进行交叉核对以验证一致性。进行组内和组间合并以解决差异，未解决的差异由仲裁员解决。报告Kappa统计量以评估评审人员之间的一致性。所有成本均使用研究所在国家公布的通货膨胀率按原始货币调整为2015年，然后转换为2015年美元。
通过标题和摘要共筛选出651篇文章，94篇进行了全文评审，28篇纳入最终评审。Kappa值为0.794。20项研究报告了直接成本，9项报告了间接成本。在美国，每年的平均直接成本总计从1442美元到21335美元不等。每年的平均间接成本从238美元到29935美元不等。12项研究使用各种工具测量了HRQoL。简式健康调查12项第2版身体成分得分在35.0至51.3之间，心理成分得分在43.5至55.0之间。健康效用值从重度OA的0.30到轻度OA的0.77不等。
每位患者的OA成本相当可观，患者的生活质量仍然较差。成本计算方法的差异是理解不同研究中OA成本真正差异的障碍。规范医疗资源项目、与OA相关成本的定义以及生产力损失衡量方法将有助于进行比较。
