Meregaglia Michela, Cairns John
Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
CeRGAS (Research Centre on Health and Social Care Management), Bocconi University, Via Roentgen 1, 20136, Milan, Italy.
Health Qual Life Outcomes. 2017 Sep 2;15(1):174. doi: 10.1186/s12955-017-0748-z.
Health state utility values (HSUVs) are essential parameters in model-based economic evaluations. This study systematically identifies HSUVs in head and neck cancer and provides guidance for selecting them from a growing body of health-related quality of life studies.
We systematically reviewed the published literature by searching PubMed, EMBASE and The Cochrane Library using a pre-defined combination of keywords. The Tufts Cost-Effectiveness Analysis Registry and the School of Health and Related Research Health Utilities Database (ScHARRHUD) specifically containing health utilities were also queried, in addition to the Health Economics Research Centre database of mapping studies. Studies were considered for inclusion if reporting original HSUVs assessed using established techniques. The characteristics of each study including country, design, sample size, cancer subsite addressed and demographics of responders were summarized narratively using a data extraction form. Quality scoring and critical appraisal of the included studies were performed based on published recommendations.
Of a total 1048 records identified by the search, 28 studies qualified for data extraction and 346 unique HSUVs were retrieved from them. HSUVs were estimated using direct methods (e.g. standard gamble; n = 10 studies), multi-attribute utility instruments (MAUIs; n = 13) and mapping techniques (n = 3); two studies adopted both direct and indirect approaches. Within the MAUIs, the EuroQol 5-dimension questionnaire (EQ-5D) was the most frequently used (n = 11), followed by the Health Utility Index Mark 3 (HUI3; n = 2), the 15D (n = 2) and the Short Form-Six Dimension (SF-6D; n = 1). Different methods and types of responders (i.e. patients, healthy subjects, clinical experts) influenced the magnitude of HSUVs for comparable health states. Only one mapping study developed an original algorithm using head and neck cancer data. The identified studies were considered of intermediate quality.
This review provides a dataset of HSUVs systematically retrieved from published studies in head and neck cancer. There is currently a lack of research for some disease phases including recurrent and metastatic cancer, and treatment-related complications. In selecting HSUVs for cost-effectiveness modeling purposes, preference should be given to EQ-5D utility values; however, mapping to EQ-5D is a potentially valuable technique that should be further developed in this cancer population.
健康状态效用值（HSUVs）是基于模型的经济评估中的关键参数。本研究系统地识别了头颈癌中的HSUVs，并为从越来越多的健康相关生活质量研究中选择这些值提供指导。
我们使用预定义的关键词组合在PubMed、EMBASE和Cochrane图书馆中系统地检索已发表的文献。除了健康经济研究中心的映射研究数据库外，还查询了塔夫茨成本效益分析登记处以及专门包含健康效用的健康与相关研究学院健康效用数据库（ScHARRHUD）。如果研究报告了使用既定技术评估的原始HSUVs，则考虑将其纳入。使用数据提取表以叙述方式总结了每项研究的特征，包括国家、设计、样本量、所涉及的癌症亚部位以及应答者的人口统计学特征。根据已发表的建议对纳入研究进行质量评分和批判性评价。
在检索到的总共1048条记录中，有28项研究符合数据提取条件，并从中检索到346个独特的HSUVs。HSUVs使用直接方法（如标准博弈；n = 10项研究）、多属性效用工具（MAUIs；n = 13）和映射技术（n = 3）进行估计；两项研究采用了直接和间接方法。在MAUIs中，欧洲五维健康量表（EQ - 5D）使用最为频繁（n = 11），其次是健康效用指数Mark 3（HUI3；n = 2）、15D（n = 2）和简式六维健康量表（SF - 6D；n = 1）。不同的方法和应答者类型（即患者、健康受试者、临床专家）会影响可比健康状态下HSUVs的大小。只有一项映射研究使用头颈癌数据开发了原始算法。所识别的研究被认为质量中等。
本综述提供了一个从已发表的头颈癌研究中系统检索到的HSUVs数据集。目前对于包括复发和转移性癌症以及治疗相关并发症在内的一些疾病阶段缺乏研究。在为成本效益建模目的选择HSUVs时，应优先考虑EQ - 5D效用值；然而，映射到EQ - 5D是一种潜在有价值的技术，应在该癌症人群中进一步开发。
