Time trade-off health state utility values for depression: a systematic review and meta-analysis

Abstract

Purpose This study aims to systematically review the literature on health utility in depression generated by time trade-off (TTO) method and to compare health state vignettes. Methods Systematic literature search was conducted following PRISMA guideline in 2020 November (updated in 2022 March) in Pubmed, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews. Random effect meta-analysis was conducted to pool vignette-based utility values of mild, moderate, and severe depression and to compare the preferences of depressed and nondepressed population. Results Overall, 264 records were found, 143 screened by title and abstract after removing duplicates, 18 assessed full text, and 14 original publications included. Majority of the studies (n = 9) used conventional TTO method, and most of the studies (n = 8) applied 10-year timeframe. Eight studies evaluated self-experienced health (own-current depression). Six studies assessed vignette-based health states of remitted, mild, moderate, and severe depression, half of them applied McSad measure based health description. Altogether, 61 different utility values have been cataloged, mean utility of self-experienced depression states (n = 33) ranged between 0.89 (current-own depression) and 0.24 (worst experienced depression). Pooled utility estimates for vignette-based mild, moderate, and severe depression was 0.75, 0.66 and 0.50, respectively. Meta-regression showed that severe depression (β = −0.16) and depressed sample populations (β = −0.13) significantly decrease vignette-based utility scores. Conclusion Our review revealed extent heterogeneity both in TTO methodology and health state vignette development. Patient’s perception of depression health states was worse than healthy respondents.

The Hidden Toll of Psychological Distress in Australian Adults and Its Impact on Health-Related Quality of Life Measured as Health State Utilities

“…This finding is in line with the previous studies. For example, a most recent survey on HSUs of depression reported that the pooled mean utilities of different depression-related health states ranged from 0.240 to 0.890 while mean utility values for mild, moderate and severe depression were 0.750, 0.660 and 0.500, respectively [ 103 ]. Another study also found that a less severe health state of depression was associated with high utility scores [ 104 ].…”

Comparative analysis of health state utility measurement methods

“…Overall In total, 14 articles met the inclusion criteria, but two publications were merged, while reporting the results of the same study [106]. An additional empirical TTO study was found by hand searching the reference lists of included articles, resulting in 14 included individual studies…”

“…previously published two articles [105,106] and two handed-in manuscripts [107,108] are presented. As main author (Péter Balázs) in the four publications, several parts of the studies were used in this thesis.…”

“…(Figure 7) Although there are several direct HSU studies in depression, the literature lacks a review to synthetise findings on utility values. The primary aim of Our previously published review therefore was to catalogue TTO utility estimates in depression-related health states [106].…”

“…capabilities with older age, higher education, living in town, being employed/student and living as married [105][106][107][108].…”