Doctoral School of Business and Management, Corvinus University of Budapest, Budapest, Hungary.
Institute of Social and Political Sciences, Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary.
Qual Life Res. 2023 Apr;32(4):923-937. doi: 10.1007/s11136-022-03253-5. Epub 2022 Sep 30.
This study aims to systematically review the literature on health utility in depression generated by time trade-off (TTO) method and to compare health state vignettes.
Systematic literature search was conducted following PRISMA guideline in 2020 November (updated in 2022 March) in Pubmed, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews. Random effect meta-analysis was conducted to pool vignette-based utility values of mild, moderate, and severe depression and to compare the preferences of depressed and nondepressed population.
Overall, 264 records were found, 143 screened by title and abstract after removing duplicates, 18 assessed full text, and 14 original publications included. Majority of the studies (n = 9) used conventional TTO method, and most of the studies (n = 8) applied 10-year timeframe. Eight studies evaluated self-experienced health (own-current depression). Six studies assessed vignette-based health states of remitted, mild, moderate, and severe depression, half of them applied McSad measure based health description. Altogether, 61 different utility values have been cataloged, mean utility of self-experienced depression states (n = 33) ranged between 0.89 (current-own depression) and 0.24 (worst experienced depression). Pooled utility estimates for vignette-based mild, moderate, and severe depression was 0.75, 0.66 and 0.50, respectively. Meta-regression showed that severe depression (β = -0.16) and depressed sample populations (β = -0.13) significantly decrease vignette-based utility scores.
Our review revealed extent heterogeneity both in TTO methodology and health state vignette development. Patient's perception of depression health states was worse than healthy respondents.
本研究旨在系统回顾时间权衡（TTO）法生成的抑郁健康效用文献，并比较健康状态描述。
按照 PRISMA 指南，于 2020 年 11 月（2022 年 3 月更新）在 Pubmed、Web of Science、PsycInfo 和 Cochrane 系统评价数据库中进行系统文献检索。采用随机效应荟萃分析对轻度、中度和重度抑郁的基于描述的效用值进行汇总，并比较抑郁和非抑郁人群的偏好。
总共发现 264 条记录，去除重复项后通过标题和摘要筛选出 143 条，评估全文后纳入 18 项原始出版物，其中 14 项符合纳入标准。大多数研究（n=9）使用传统的 TTO 方法，大多数研究（n=8）应用 10 年时间框架。8 项研究评估了自我体验的健康状况（自身当前的抑郁）。6 项研究评估了缓解、轻度、中度和重度抑郁的基于描述的健康状态，其中一半应用了 McSad 健康描述测量。总共列出了 61 种不同的效用值，自我体验的抑郁状态（n=33）的平均效用值在 0.89（自身当前的抑郁）和 0.24（经历过的最严重的抑郁）之间。基于描述的轻度、中度和重度抑郁的汇总效用估计值分别为 0.75、0.66 和 0.50。元回归显示，重度抑郁（β=-0.16）和抑郁样本人群（β=-0.13）显著降低了基于描述的效用评分。
我们的综述显示 TTO 方法和健康状态描述的发展存在很大的异质性。患者对抑郁健康状态的感知比健康受访者更差。
