Gonzalez Cristian, Espinoza Manuel, Libuy Matías, Crispi Francisca, Riquelme Arnoldo, Alarid-Escudero Fernando, Latorre Gonzalo, Pizarro Margarita, Cuadrado Cristóbal
Escuela de Salud Pública, Universidad de Chile, Santiago de Chile, RM, Chile.
Departamento Salud Pública, Pontificia Universidad Católica de Chile, Santiago de Chile, RM, Chile; Centro de Prevención y Control de Cáncer (CECAN), Santiago de Chile, RM, Chile.
Value Health Reg Issues. 2025 Mar;46:101063. doi: 10.1016/j.vhri.2024.101063. Epub 2025 Feb 1.
Gastric cancer (GC) imposes a significant burden of disease globally. Multiple treatments are available but are associated with high costs and potentially detrimental effects on quality of life. The utility values of health status are measures of patient preference over quality of life, which are increasingly used for health and economic decision-making. Currently, there is little systematized information on the utility values for different stages of GC. This systematic review synthesizes and meta-analyses the literature on GC utilities.
A search was conducted in PubMed, Embase, MEDLINE, and Cochrane Library for studies reporting utility values calculated using direct and indirect methods. Information from the selected studies was extracted and appraised, and meta-analyses of utility values based on GC health states were performed.
Twelve studies involving 4585 patients were included. Random-effects meta-analysis estimates showed a mean utility of 0.77 (95% CI 0.7-0.85) for stage I, 0.75 (95% CI 0.65-0.85) for stage II, 0.70 (95% CI 0.63-0.96) for stage III, and 0.64 (95% CI 0.56-0.32) for stage IV. All estimates showed considerable heterogeneity.
Our study provides an updated overview of the literature on utility values in GC and presents a discussion of the relevance of GC stages for its analysis. Decision-makers should consider patients' preferences in the proposal of policies and clinical decisions.
胃癌在全球造成了重大的疾病负担。有多种治疗方法可供选择，但这些方法成本高昂，且可能对生活质量产生不利影响。健康状况的效用值是衡量患者对生活质量偏好的指标，越来越多地用于健康和经济决策。目前，关于不同阶段胃癌效用值的系统信息很少。本系统评价综合并荟萃分析了有关胃癌效用值的文献。
在PubMed、Embase、MEDLINE和Cochrane图书馆中进行检索，以查找报告使用直接和间接方法计算的效用值的研究。提取并评估所选研究的信息，并基于胃癌健康状态对效用值进行荟萃分析。
纳入了12项研究，涉及4585名患者。随机效应荟萃分析估计显示，I期的平均效用值为0.77（95%置信区间0.7 - 0.85），II期为0.75（95%置信区间0.65 - 0.85），III期为0.70（95%置信区间0.63 - 0.96），IV期为0.64（95%置信区间0.56 - 0.32）。所有估计值均显示出相当大的异质性。
我们的研究提供了关于胃癌效用值文献的最新综述，并讨论了胃癌分期在其分析中的相关性。决策者在制定政策和临床决策时应考虑患者的偏好。
