Centre for Applied Health Economics, Griffith University, Brisbane, Australia.
Assessment in Medicine GmbH, Berlin, Germany.
BMC Cancer. 2022 Jan 10;22(1):52. doi: 10.1186/s12885-021-09140-5.
To synthesise EQ5D health state utility values in Chinese women with breast cancer for parameterising a cost utility model.
Eligible studies had to report health state utility values measured by EQ-5D in Chinese women diagnosed with breast cancer. Risk of bias was assessed using the Newcastle Ottawa Scale (NOS). Data from single arm studies was pooled using meta-analysis of single proportions to provide overall point estimates and 95% confidence intervals for fixed and random effects models using the inverse variance and Der Simonian-Laird methods respectively. Heterogeneity was evaluated using the I statistic and sensitivity analysis and meta-regression were conducted.
Five papers were included, when all studies were combined (n = 4,100) the mean utility (95% confidence interval) for random effects model was 0.83 (0.78, 0.89); for TNM 0-1 0.85 (0.75, 0.95); for TNM II 0.85 (0.78, 0.93); for TNM III 0.83 (0.77, 0.90) and for TNM IV 0.73 (0.63, 0.82).The utility of patients in State P (first year after primary breast cancer) 0.84 (0.80, 0.88); in State R (first year after recurrence) 0.73 (0.69, 0.76), in State S (second and following years after primary breast cancer or recurrence) 0.88 (0.83, 0.92); and in State M (metastatic disease) 0.78 (0.74, 0.82). Mean utility for duration since diagnosis 13 to 36 months was 0.88 (0.80, 0.96, I =95%); for 37 to 60 months 0.89 (0.82, 0.96, I =90%); for more than 60 months 0.86 (0.76, 0.96, I =90%). Mean utility for chemotherapy was 0.86 (0.79, 0.92, I =97%); for radiotherapy 0.83 (0.69, 0.96, I =97%); surgery 0.80 (0.69, 0.91, I =98%); concurrent chemo-radiation 0.70 (0.60, 0.81, I =86%) and endocrine therapy 0.90 (0.83, 0.97, I =91%).
This study synthesises the evidence for health state utility values for Chinese women with breast cancer which is useful to inform cost utility models.
综合中国女性乳腺癌患者的 EQ5D 健康状况效用值，为成本效用模型提供参数。
合格的研究必须报告在中国女性乳腺癌患者中使用 EQ-5D 测量的健康状况效用值。使用纽卡斯尔-渥太华量表（NOS）评估偏倚风险。使用单一比例的荟萃分析汇总来自单臂研究的数据，使用逆方差和德西蒙尼-莱尔德方法分别为固定和随机效应模型提供总体点估计和 95%置信区间。使用 I 统计量评估异质性，并进行敏感性分析和荟萃回归。
纳入了 5 篇论文，当所有研究合并（n=4100）时，随机效应模型的平均效用（95%置信区间）为 0.83（0.78，0.89）；TNM 0-1 为 0.85（0.75，0.95）；TNM II 为 0.85（0.78，0.93）；TNM III 为 0.83（0.77，0.90）；TNM IV 为 0.73（0.63，0.82）。患者在状态 P（原发性乳腺癌后第一年）的效用为 0.84（0.80，0.88）；在状态 R（复发后第一年）为 0.73（0.69，0.76），在状态 S（原发性乳腺癌或复发后第二年及以后）为 0.88（0.83，0.92）；在状态 M（转移性疾病）为 0.78（0.74，0.82）。自诊断后 13 至 36 个月的平均效用为 0.88（0.80，0.96，I=95%）；37 至 60 个月为 0.89（0.82，0.96，I=90%）；60 个月以上为 0.86（0.76，0.96，I=90%）。化疗的平均效用为 0.86（0.79，0.92，I=97%）；放疗为 0.83（0.69，0.96，I=97%）；手术为 0.80（0.69，0.91，I=98%）；同期放化疗为 0.70（0.60，0.81，I=86%）；内分泌治疗为 0.90（0.83，0.97，I=91%）。
本研究综合了中国女性乳腺癌患者健康状况效用值的证据，这对成本效用模型很有帮助。
