Identification, Review, and Use of Health State Utilities in Cost-Effectiveness Models: An ISPOR Good Practices for Outcomes Research Task Force Report

Brazier, John; Ara, Roberta; Azzabi, Ismail; Busschbach, Jan J. V.; Chevrou‐Séverac, Hélène; Crawford, Bruce; Cruz, Luciane Nascimento; Karnon, Jonathan; Lloyd, Andrew; Paisley, Suzy; Pickard, A. Simon

doi:10.1016/j.jval.2019.01.004

Cited by 125 publications

(146 citation statements)

References 30 publications

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“…To account for further sources of heterogeneity, a sensitivity analysis pooled HSUVs only across studies that explicitly used the three-level EQ-5D (EQ-5D-3L) instrument. A second sensitivity analysis included only studies that used the EQ-5D instrument (regardless of the version), while also applying the tariff matching the country of HRQoL respondents [9,27,28]. This second sensitivity analysis aimed to provide the methodologically most comparable HSUVs for each available country.…”

Section: Meta-analysis and Statistical Methodsmentioning

confidence: 99%

“…Studies that scored insufficiently on any of these relevance items were excluded from subsequent analyses. This approach prioritises consistency of the methodology across studies [9].…”

Section: Data Extraction and Critical Appraisalmentioning

confidence: 99%

“…Using different HSUVs can lead to different policies being ranked as cost effective [8]. Therefore, it is important to systematically identify appropriate and high-quality HSUVs for economic evaluations [9].…”

Section: Introductionmentioning

confidence: 99%

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Systematic Review and Meta-Analysis of Community- and Choice-Based Health State Utility Values for Lung Cancer

2020

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Background Using appropriate health state utility values (HSUVs) is critical for economic evaluation of new lung cancer interventions, such as low-dose computed tomography screening and immunotherapy. Therefore, we provide a systematic review and meta-analysis of community-and choice-based HSUVs for lung cancer. Methods On 6 March 2017, we conducted a systematic search of the following databases: Embase, Ovid MEDLINE, Web of Science, Cochrane CENTRAL, Google Scholar, and the School of Health and Related Research Health Utility Database. The search was updated on 17 April 2019. Studies reporting mean or median lung cancer-specific HSUVs including a measure of variance were included and assessed for relevance and validity. Studies with high relevance (i.e. community-and choicebased) were further analysed. Mean HSUVs were pooled using random-effects models for all stages, stages I-II, and stages III-IV. For studies with a control group, we calculated the disutility due to lung cancer. A sensitivity analysis included only the methodologically most comparable studies (i.e. using the EQ-5D instrument and matching tariff). Subgroup analyses were conducted by time to death, histology, sex, age, treatment modality, treatment line, and progression status. Results We identified and analysed 27 studies of high relevance. The pooled HSUV was 0.68 (95% confidence interval [CI] 0.61-0.75) for all stages, 0.78 (95% CI 0.70-0.86) for stages I-II, and 0.69 (95% CI 0.65-0.73) for stages III-IV (p = 0.02 vs. stage I-II). Heterogeneity was present in each pooled analysis (p < 0.01; I 2 = 92-99%). Disutility due to lung cancer ranged from 0.11 (95% CI 0.05-0.17) to 0.27 (95% CI 0.18-0.36). In the sensitivity analysis with the methodologically most comparable studies, stage-specific HSUVs varied by country. Such studies were only identified for Canada, China, Spain, the UK, the USA, Denmark, Germany, and Thailand. In the subgroup analysis by time to death, HSUVs for metastatic non-small-cell lung cancer ranged from 0.83 (95% CI 0.82-0.85) at ≥ 360 days from death to 0.56 (95% CI 0.46-0.66) at < 30 days from death. Among patients with metastatic non-small-cell lung cancer, HSUVs were lower for those receiving third-or fourth-line treatment and for those with progressed disease. Results of subgroup analyses by histology, sex, age, and treatment modality were ambiguous. Conclusions The presented evidence supports the use of stage-and country-specific HSUVs. However, such HSUVs are unavailable for most countries. Therefore, our pooled HSUVs may provide the best available stage-specific HSUVs for most countries. For metastatic non-small-cell lung cancer, adjusting for the decreased HSUVs in the last year of life may be considered, as may further stratification of HSUVs by treatment line or progression status. If required, HSUVs for other health states may be identified using our comprehensive breakdown of study characteristics.

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Section: Meta-analysis and Statistical Methodsmentioning

confidence: 99%

“…Studies that scored insufficiently on any of these relevance items were excluded from subsequent analyses. This approach prioritises consistency of the methodology across studies [9].…”

Section: Data Extraction and Critical Appraisalmentioning

confidence: 99%

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Systematic Review and Meta-Analysis of Community- and Choice-Based Health State Utility Values for Lung Cancer

2020

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“…The adoption of QALYs is feasible in SSA [65], and awareness raising together with action and support for research efforts at developing value sets for Ghana through peer or South-South channels may be an important means of methods development [7]. This highlights the importance of having a reference case [22] that signals preference (and creates a demand) for certain types of data [78].…”

Section: Implications For Policy and Practicementioning

confidence: 99%

What do we need to know? Data sources to support evidence-based decisions using health technology assessment in Ghana

Hollingworth

Downey

Ruiz

et al. 2020

Health Res Policy Sys

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Introduction Health technology assessment (HTA) is an effective tool to support priority setting and generate evidence for decision making especially en route to achieving universal health coverage (UHC). We assessed the capacity needs, policy areas of demand, and perspectives of key stakeholders for evidence-informed decision making in Nigeria where HTA is still new. Methods We surveyed 31 participants including decision makers, policy makers, academic researchers, civil society organizations, community-based organizations, development partners, health professional organizations. We revised an existing survey to qualitatively examine the need, policy areas of demand, and perspectives of stakeholders on HTA. We then analyzed responses and explored key themes. Results Most respondents were associated with organizations that generated or facilitated health services research. Research institutes highlighted their ability to provide expertise and skills for HTA research but some respondents noted a lack of human capacity for HTA. HTA was considered an important and valuable priority-setting tool with a key role in the design of health bene ts packages, clinical guideline development, and service improvement. Public health programs, medicines and vaccines were the three main technology types that would especially bene t from the application of HTA. The perceived availability and accessibility of suitable local data to support HTA varied widely but was mostly considered inadequate and limited. Respondents needed evidence on health system nancing, health service provision, burden of disease and noted a need for training support in research methodology, HTA and data management Conclusion The use of HTA by policymakers and communities in Nigeria is very limited mainly due to inadequate and insu cient capacity to produce and use HTA. Developing sustainable and institutionalized HTA systems requires in-country expertise and active participation from a range of stakeholders. Stakeholder participation in identifying HTA topics and conducting relevant research will enhance the use of HTA evidence produced for decision making. Therefore, the identi ed training needs for HTA and possible research topics should be considered a priority in establishing HTA for evidenceinformed policy making for achieving UHC particularly among the most vulnerable people in Nigeria.

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“…(2)(3) Health results are the coordinates to attain quality and therefore clinical safety, as they indicate effects that can be attributed to the presence or absence of intervention of a state of health, behavior or perception that are susceptible to this intervention. (4) There is worldwide consensus showing how scientific evidence increasingly backs the need to implement results that evaluate the contribution of caregiving to clinical quality and safety, demonstrating the existence of results sensitive to nursing practice (RSPE). (5)(6) RSPEs may be defined as desired or unwanted changes in individuals' state of health as a result of the practice of nursing interventions.…”

mentioning

confidence: 99%

Resultados sensibles a la práctica enfermera: investigación clínica y evidencia

Pórcel‐Gálvez

2019

Rev. Gaúcha Enferm.

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Identification, Review, and Use of Health State Utilities in Cost-Effectiveness Models: An ISPOR Good Practices for Outcomes Research Task Force Report

Cited by 125 publications

References 30 publications

Systematic Review and Meta-Analysis of Community- and Choice-Based Health State Utility Values for Lung Cancer

Systematic Review and Meta-Analysis of Community- and Choice-Based Health State Utility Values for Lung Cancer

What do we need to know? Data sources to support evidence-based decisions using health technology assessment in Ghana

Resultados sensibles a la práctica enfermera: investigación clínica y evidencia

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