Health state utilities in patients with diabetic retinopathy, diabetic macular oedema and age-related macular degeneration: a systematic review

BMC Ophthalmology

Research Article

Edith Poku¹  Jill Carlton¹  John Brazier¹  Alberto Ferreira² 

[1] Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, 30 Regent Court, S1 2DA, Sheffield, England;Novartis Pharma AG, Postfach, CH-4002, Basel, Switzerland;

关键词: Health utility;    Visual acuity;    Diabetic retinopathy;    Age-related macular degeneration;   

DOI  :  10.1186/1471-2415-13-74

 received in 2012-10-10, accepted in 2013-09-26,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundHealth state utility values (HSUVs) are important in the assessment of the cost effectiveness of new interventions. In the case of visual conditions, models generally tend have tended to be built around a set of health states defined by visual acuity (VA). The aim of this review was to assess the impact of VA on HSUVs in patients with diabetic retinopathy, diabetic macular oedema or age-related macular degeneration.MethodsA systematic literature search was undertaken in major bibliographic databases to identify articles reporting on the relationship between HSUVs and vision. Data were extracted for population characteristics, visual levels and estimated utilities. Evidence from reported statistical models, where available, was considered in the evaluation of vision in the better-seeing eye and the worse-seeing eye. Due to the heterogeneity of included studies, a narrative synthesis was undertaken.ResultsOf the 17 relevant studies, 9 studies had data that could be used in the analysis of the impact of vision on HSUVs. Visual loss was associated with a marked impact on health utilities. However, the relationship was not comparable between conditions or by measure of HSUVs. Key results included the finding that overall, self-rated time-trade off estimates were more likely to discriminate between different VA levels than EQ-5D values. Additionally, a stronger correlation was observed between HSUVs and better-seeing eye VA compared to worse-seeing eye VA.ConclusionsVisual acuity has a significant impact on HSUVs. Nevertheless, care must be taken in the interpretation and use of estimates in cost-effectiveness models due to differences in measures and population diversity.

【 授权许可】

CC BY   
© Poku et al.; licensee BioMed Central Ltd. 2013