The impact of age on health utility values for older women with early-stage breast cancer: a systematic review and meta-regression

Health and Quality of Life Outcomes

Review

Yubo Wang¹  Li-Chia Chen¹  Douglas Steinke¹  Sean P. Gavan²  Kwok-Leung Cheung³ 

[1] Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Stopford Building, Oxford Road, 1stFloor Stopford Building, M13 9PT, Manchester, UK;Manchester Centre for Health Economics, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, M13 9PL, Manchester, UK;School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Uttoxeter Road, DE22 3DT, Derby, UK;

关键词: Early-stage breast cancer;    Economic evaluation;    Health state utility values;    Meta-regression;    Older women;    Systematic review;   

DOI  :  10.1186/s12955-022-02067-w

 received in 2022-08-16, accepted in 2022-11-07,  发布年份 2022

来源: Springer

【 摘 要 】

IntroductionAn increasing number of postmenopausal women are diagnosed with breast cancer at an older age (≥ 70 years). There is a lack of synthesised health utility data to support decision-making for managing breast cancer in this older population. This study aimed to identify the availability of, and the subsequent impact of age on, health state utility values (HSUVs) measured by the EQ-5D for older women with early-stage breast cancer. MethodThis systematic review identified EQ-5D (3L or 5L version) HSUVs for postmenopausal women with early-stage breast cancer. Studies were identified from a previous systematic review (inception to 2009) and an electronic database search (Medline and Embase; 2009 to September 2021). Mean HSUVs were summarised by health state. Quality appraisal was performed on studies reporting HSUVs for older ages (≥ 70 years). Multivariable meta-regression assessed the association between HSUVs and age, health state, treatments received, and time of measuring the utility values (greater or less than one year post-treatment). ResultsFifty EQ-5D HSUVs were identified from 13 studies. Mean HSUVs decreased as health state worsened: from the stable (mean=0.83) to progression (mean=0.79) and advanced (mean=0.68) states. Two studies reported six HSUVs estimated from the sample of women with a mean age ≥ 70. Meta-regression model fit improved by including age as an independent variable and attenuated the estimated utility decrements associated with worse health states. Utility decrements for the progression and advanced states were -0.052 (95%CI: -0.097, -0.007) and -0.143 (95%CI: -0.264, -0.022) respectively. The breast cancer-specific utility decrement associated with a one-year increase in age was -0.001 (95%CI: -0.004, 0.002). ConclusionRelevant and accurate HSUVs are essential to help support decision-making about the most effective and cost-effective ways to manage early-stage breast cancer in older women. Age has a vital role in determining health utility values in this population. This study provides analysts and decision-makers with HSUVs and utility decrements that reflect the disease process in this older population.

【 授权许可】

CC BY   
© The Author(s) 2022

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