Systematic Review: Health-State Utilities in Liver Disease: A Systematic Review

David J. McLernon, John Dillon and Peter T. Donnan
Additional contact information
David J. McLernon: Tayside Centre for General Practice, Health Informatics Centre, d.mclernon@abdn.ac.uk
John Dillon: Department of Digestive Diseases and Clinical Nutrition, University of Dundee, Scotland
Peter T. Donnan: Tayside Centre for General Practice, Health Informatics Centre

Medical Decision Making, 2008, vol. 28, issue 4, 582-592

Abstract: Objectives. Health-state utilities are essential for cost-utility analysis. Few estimates exist for liver disease in the literature. The authors' aim was to conduct a systematic review of health-state utilities in liver disease, to look at the variation of study designs used, and to pool utilities for some liver disease states. Methods. A search of MED-LINE, EMBASE, and CINAHL from 1966 to September 2006 was conducted including key words related to liver disease and utility measuring tools. Articles were included if health-state utility tools or expert opinion were used. Variance-weighted mean utility estimates were pooled using metaregression adjusting for disease state and utility assessment method. Results. Thirty studies measured utilities of liver diseases/disease states. Half of these estimated utilities for hepatitis viruses: hepatitis A ( n = 1), hepatitis B ( n = 4), and hepatitis C ( n = 10). Others included liver transplant ( n= 6) and chronic liver disease ( n= 5) populations. Twelve utility methods were used throughout. The EQ-5D ( n = 10) was most popular method, followed by visual analogue scale ( n = 9), time tradeoff ( n = 6), and standard gamble ( n = 4). Respondents were patients ( n= 16), an expert panel ( n = 10), non — liver diseases adults ( n= 2), patient and expert ( n = 1), and patient and healthy adult ( n = 1). Type of perspective included community ( n= 21), patient ( n= 4), and both ( n = 5). The pooled mean estimates in hepatitis C with moderate disease, compensated cirrhosis, decompensated cirrhosis, and post — liver transplant using the EQ-5D were 0.75, 0.75, 0.67, and 0.71, respectively. The change in these utilities using different methods were - 0.07 (visual analogue scale), - 0.01 (health utilities index version 3), + 0.04 (standard gamble), + 0.08 (health utilities index version 2), + 0.12 (time tradeoff), and + 0.15 (standard gamble — transformed visual analogue scale). Conclusions. The authors have created a valuable liver disease — based utility resource from which researchers and policy makers can easily view all available utility estimates from the literature. They have also estimated health-state utilities for major states of hepatitis C.

Keywords: health-state utility; liver disease; systematic review; meta-analysis; hepatitis C. (search for similar items in EconPapers)
Date: 2008
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Citations: View citations in EconPapers (10)

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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:28:y:2008:i:4:p:582-592

DOI: 10.1177/0272989X08315240

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