Centre for Healthcare Transformation, Cancer and Palliative Care Outcomes, Queensland University of Technology, Level 7, Q Block, 66 Must Avenue, Kelvin Grove, Brisbane, QLD, Australia.
Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
Qual Life Res. 2024 Nov;33(11):2899-2914. doi: 10.1007/s11136-024-03734-9. Epub 2024 Aug 22.
Older people with acute myeloid leukaemia (AML) have a poor prognosis, reduced health-related quality of life (HRQoL) and require substantial healthcare resources. The objectives of this systematic review were to determine what health state utility values (HSUVs) are reported in the literature that can be used in economic evaluations of interventions for older people with AML, identify research gaps, and discuss directions for future research.
The following databases were searched for studies published from inception until Feb 2023: PubMed, EMBASE, CINAHL, PsycINFO, Cochrane, and EconLit. Studies were included if they reported on HSUVs of people with AML >60 years, or HRQoL data that could be mapped to HSUVs using currently published algorithms.
Of 532 studies identified, 7 met inclusion (4 full studies and 3 conference abstracts). Twenty-eight potentially eligible studies were excluded as they did not report HRQoL measures in sufficient detail to be mapped to utility values. Included studies reported on health states of newly diagnosed disease (n=4 studies), intensive therapy (n=1 study), controlled remission (n=3 studies), and relapsed or refractory disease (n=2 studies). No studies reported on low intensity therapy or supportive care health states. Utility values were largely reported via the EuroQol and ranged from 0.535 (intensive therapy) to 0.834 (controlled remission).
There are gaps in knowledge on HSUVs for older people with AML, particularly for certain treatment-related health states. Future articles should publish comprehensive HRQoL outcomes to enable use in economic evaluation.
老年急性髓系白血病（AML）患者预后较差，健康相关生活质量（HRQoL）较低，需要大量医疗保健资源。本系统评价的目的是确定文献中报告的哪些健康状态效用值（HSUV）可用于老年 AML 患者干预措施的经济评估，确定研究空白，并讨论未来研究方向。
从开始到 2023 年 2 月，我们在以下数据库中搜索发表的研究：PubMed、EMBASE、CINAHL、PsycINFO、Cochrane 和 EconLit。如果研究报告了年龄>60 岁的 AML 患者的 HSUV 或 HRQoL 数据，并且可以使用当前发表的算法将其映射到 HSUV，则将其纳入研究。
在 532 项研究中，有 7 项符合纳入标准（4 项完整研究和 3 项会议摘要）。28 项潜在合格研究因未详细报告 HRQoL 测量值而被排除在外，无法映射到效用值。纳入的研究报告了新诊断疾病（n=4 项研究）、强化治疗（n=1 项研究）、控制缓解（n=3 项研究）和复发或难治性疾病（n=2 项研究）的健康状况。没有研究报告低强度治疗或支持性护理的健康状况。效用值主要通过欧洲质量调整生命年（EQ-5D）报告，范围从强化治疗的 0.535 到控制缓解的 0.834。
老年 AML 患者 HSUV 知识存在空白，特别是在某些与治疗相关的健康状况方面。未来的文章应发表全面的 HRQoL 结果，以用于经济评估。
