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Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis
BACKGROUND: Utility estimates are important health outcomes for economic evaluation of care and treatment interventions for patients with HIV/AIDS. We conducted a systematic review and meta-analysis of utility measurements to examine the performance of preference-based instruments, estimate health u...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307193/ https://www.ncbi.nlm.nih.gov/pubmed/25609449 http://dx.doi.org/10.1186/s12913-014-0640-z |
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author | Tran, Bach Xuan Nguyen, Long Hoang Ohinmaa, Arto Maher, Rachel Marie Nong, Vuong Minh Latkin, Carl A |
author_facet | Tran, Bach Xuan Nguyen, Long Hoang Ohinmaa, Arto Maher, Rachel Marie Nong, Vuong Minh Latkin, Carl A |
author_sort | Tran, Bach Xuan |
collection | PubMed |
description | BACKGROUND: Utility estimates are important health outcomes for economic evaluation of care and treatment interventions for patients with HIV/AIDS. We conducted a systematic review and meta-analysis of utility measurements to examine the performance of preference-based instruments, estimate health utility of patients with HIV/AIDS by disease stages, and investigate changes in their health utility over the course of antiretroviral treatment. METHODS: We searched PubMed/Medline, Cochrane Database of Systematic Review, NHS Economic Evaluation Database and Web of Science for English-language peer-reviewed papers published during 2000–2013. We selected 49 studies that used 3 direct and 6 indirect preference based instruments to make a total of 218 utility measurements. Random effect models with robust estimation of standard errors and multivariate fractional polynomial regression were used to obtain the pooled estimates of utility and model their trends. RESULTS: Reliability of direct-preference measures tended to be lower than other types of measures. Utility elicited by two of the indirect preference measures - SF-6D (0.171) and EQ-5D (0.114), and that of Time-Trade off (TTO) (0.151) was significantly different than utility elicited by Standard Gamble (SG). Compared to asymptomatic HIV patients, symptomatic and AIDS patients reported a decrement of 0.025 (p&#×2009;=&#×2009;0.40) and 0.176 (p&#×2009;=&#×2009;0.001) in utility scores, adjusting for method of assessment. In longitudinal studies, the pooled health utility of HIV/AIDS patients significantly decreased in the first 3 months of treatment, and rapidly increased afterwards. Magnitude of change varied depending on the method of assessment and length of antiretroviral treatment. CONCLUSION: The study provides an accumulation of evidence on measurement properties of health utility estimates that can help inform the selection of instruments for future studies. The pooled estimates of health utilities and their trends are useful in economic evaluation and policy modelling of HIV/AIDS treatment strategies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-014-0640-z) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4307193 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-43071932015-01-28 Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis Tran, Bach Xuan Nguyen, Long Hoang Ohinmaa, Arto Maher, Rachel Marie Nong, Vuong Minh Latkin, Carl A BMC Health Serv Res Research Article BACKGROUND: Utility estimates are important health outcomes for economic evaluation of care and treatment interventions for patients with HIV/AIDS. We conducted a systematic review and meta-analysis of utility measurements to examine the performance of preference-based instruments, estimate health utility of patients with HIV/AIDS by disease stages, and investigate changes in their health utility over the course of antiretroviral treatment. METHODS: We searched PubMed/Medline, Cochrane Database of Systematic Review, NHS Economic Evaluation Database and Web of Science for English-language peer-reviewed papers published during 2000–2013. We selected 49 studies that used 3 direct and 6 indirect preference based instruments to make a total of 218 utility measurements. Random effect models with robust estimation of standard errors and multivariate fractional polynomial regression were used to obtain the pooled estimates of utility and model their trends. RESULTS: Reliability of direct-preference measures tended to be lower than other types of measures. Utility elicited by two of the indirect preference measures - SF-6D (0.171) and EQ-5D (0.114), and that of Time-Trade off (TTO) (0.151) was significantly different than utility elicited by Standard Gamble (SG). Compared to asymptomatic HIV patients, symptomatic and AIDS patients reported a decrement of 0.025 (p&#×2009;=&#×2009;0.40) and 0.176 (p&#×2009;=&#×2009;0.001) in utility scores, adjusting for method of assessment. In longitudinal studies, the pooled health utility of HIV/AIDS patients significantly decreased in the first 3 months of treatment, and rapidly increased afterwards. Magnitude of change varied depending on the method of assessment and length of antiretroviral treatment. CONCLUSION: The study provides an accumulation of evidence on measurement properties of health utility estimates that can help inform the selection of instruments for future studies. The pooled estimates of health utilities and their trends are useful in economic evaluation and policy modelling of HIV/AIDS treatment strategies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-014-0640-z) contains supplementary material, which is available to authorized users. BioMed Central 2015-01-22 /pmc/articles/PMC4307193/ /pubmed/25609449 http://dx.doi.org/10.1186/s12913-014-0640-z Text en © Tran et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Tran, Bach Xuan Nguyen, Long Hoang Ohinmaa, Arto Maher, Rachel Marie Nong, Vuong Minh Latkin, Carl A Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis |
title | Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis |
title_full | Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis |
title_fullStr | Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis |
title_full_unstemmed | Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis |
title_short | Longitudinal and cross sectional assessments of health utility in adults with HIV/AIDS: a systematic review and meta-analysis |
title_sort | longitudinal and cross sectional assessments of health utility in adults with hiv/aids: a systematic review and meta-analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307193/ https://www.ncbi.nlm.nih.gov/pubmed/25609449 http://dx.doi.org/10.1186/s12913-014-0640-z |
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