A Systematic Review and Meta-analysis of Childhood Health Utilities

Joseph Kwon, Sung Wook Kim, Wendy J. Ungar, Kate Tsiplova, Jason Madan and Stavros Petrou
Additional contact information
Joseph Kwon: Department of Economics, University of Warwick, Coventry, UK
Sung Wook Kim: Warwick Medical School, University of Warwick, Coventry, UK
Wendy J. Ungar: Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada
Kate Tsiplova: Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada
Jason Madan: Warwick Medical School, University of Warwick, Coventry, UK
Stavros Petrou: Warwick Medical School, University of Warwick, Coventry, UK

Medical Decision Making, 2018, vol. 38, issue 3, 277-305

Abstract: Background. A common feature of most reviews or catalogues of health utilities has been their focus on adult health states or derivation of values from adult populations. More generally, utility measurement in or on behalf of children has been constrained by several methodological concerns. The objective of this study was to conduct the first comprehensive systematic review and meta-analysis of primary utility data for childhood conditions and descriptors, and to determine the effects of methodological factors on childhood utilities. Methods. The review followed PRISMA guidelines. PubMed, Embase, Web of Science, PsycINFO, EconLit, CINAHL and Cochrane Library were searched for primary studies reporting health utilities for childhood conditions or descriptors using direct or indirect valuation methods. The Paediatric Economic Database Evaluation (PEDE) Porject was also searched for cost-utility analyses with primary utility values. Mean or median utilities for each of the main samples were catalogued, and weighted averages of utilities for each health condition were estimated, by valuation method. Mixed-effects meta-regression using hierarchical linear modeling was conducted for the most common valuation methods to estimate the utility decrement for each health condition category relative to general childhood population health, as well as the independent effects of methodological factors. Results. The literature searches resulted in 272 eligible studies. These yielded 3,414 utilities when all sub-groups were considered, covering all ICD-10 chapters relevant to childhood health, 19 valuation methods, 12 respondent types, 8 modes of administration, and data from 36 countries. A total of 1,191 utility values were obtained when only main study samples were considered, and these were catalogued by health condition or descriptor, and methodological characteristics. 1,073 mean utilities for main samples were used for fixed-effects meta-analysis by health condition and valuation method. Mixed-effects meta-regressions estimated that 53 of 76 ICD-10 delineated health conditions, valued using the HUI3, were associated with statistically significant utility decrements relative to general population health, whereas 38 of 57 valued using a visual analog scale (VAS) were associated with statistically significant VAS decrements. For both methods, parental proxy assessment was associated with overestimation of values, whereas adolescents reported lower values than children under 12 y. VAS responses were more heavily influenced by mode of administration than the HUI3. Conclusion. Utilities and their associated distributions, as well as the independent contributions of methodological factors, revealed by this systematic review and meta-analysis can inform future economic evaluations within the childhood context.

Keywords: childhood health states; economic evaluation; health utility; hierarchical linear model; meta-analysis; meta-regression; pediatric economic database evaluation; PRISMA; systematic review (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X17732990 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:38:y:2018:i:3:p:277-305

DOI: 10.1177/0272989X17732990

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().