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Disutility associated with cancer screening programs: A systematic review

OBJECTIVES: Disutility allows to identify how much population values intervention-related harms contributing to knowledge on the benefits/harms ratio of cancer screening programs. This systematic review evaluates disutility related to cancer screening applying a utility theory framework. METHODS: Us...

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Detalles Bibliográficos
Autores principales: Li, Lin, Severens, J. L. (Hans), Mandrik, Olena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6655768/
https://www.ncbi.nlm.nih.gov/pubmed/31339958
http://dx.doi.org/10.1371/journal.pone.0220148
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author Li, Lin
Severens, J. L. (Hans)
Mandrik, Olena
author_facet Li, Lin
Severens, J. L. (Hans)
Mandrik, Olena
author_sort Li, Lin
collection PubMed
description OBJECTIVES: Disutility allows to identify how much population values intervention-related harms contributing to knowledge on the benefits/harms ratio of cancer screening programs. This systematic review evaluates disutility related to cancer screening applying a utility theory framework. METHODS: Using a predefined protocol, Embase, Medline Ovid, Web of Science, Cochrane, Google scholar and supplementary sources were systematically searched. The framework grouped disutilities associated with breast, cervical, lung, colorectal, and prostate cancer screening programs into the screening, diagnostic work up, and treatment phases. We assessed the quality of included studies according to the relevance to target population, risk of bias, appropriateness of measure and the time frame. RESULTS: Out of 2840 hits, we included 38 studies, of which 27 measured (and others estimated) disutilities. Around 70% of studies had medium to high-level quality. Measured disutilities and Quality Adjusted Life Years loss were 0–0.03 and 0–0.0013 respectively in screening phases. Both disutilities and Quality Adjusted Life Years loss had similar ranges in diagnostic work up (0–0.26), and treatment (0.09–0.27) phases. We found no measured disutilities available for lung cancer screening and—little evidence for disutilities in treatment phase. Almost 40% of the estimated disutility values were above the range of measured ones. CONCLUSIONS: Cancer screening programs led to low disutities related to screening phase, and low to moderate disutilities related to diagnostic work up and treatment phases. These disutility values varied by the measurement instrument applied, and were higher in studies with lower quality. The estimated disutility values comparing to the measured ones tended to overestimate the harms.
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spelling pubmed-66557682019-08-07 Disutility associated with cancer screening programs: A systematic review Li, Lin Severens, J. L. (Hans) Mandrik, Olena PLoS One Research Article OBJECTIVES: Disutility allows to identify how much population values intervention-related harms contributing to knowledge on the benefits/harms ratio of cancer screening programs. This systematic review evaluates disutility related to cancer screening applying a utility theory framework. METHODS: Using a predefined protocol, Embase, Medline Ovid, Web of Science, Cochrane, Google scholar and supplementary sources were systematically searched. The framework grouped disutilities associated with breast, cervical, lung, colorectal, and prostate cancer screening programs into the screening, diagnostic work up, and treatment phases. We assessed the quality of included studies according to the relevance to target population, risk of bias, appropriateness of measure and the time frame. RESULTS: Out of 2840 hits, we included 38 studies, of which 27 measured (and others estimated) disutilities. Around 70% of studies had medium to high-level quality. Measured disutilities and Quality Adjusted Life Years loss were 0–0.03 and 0–0.0013 respectively in screening phases. Both disutilities and Quality Adjusted Life Years loss had similar ranges in diagnostic work up (0–0.26), and treatment (0.09–0.27) phases. We found no measured disutilities available for lung cancer screening and—little evidence for disutilities in treatment phase. Almost 40% of the estimated disutility values were above the range of measured ones. CONCLUSIONS: Cancer screening programs led to low disutities related to screening phase, and low to moderate disutilities related to diagnostic work up and treatment phases. These disutility values varied by the measurement instrument applied, and were higher in studies with lower quality. The estimated disutility values comparing to the measured ones tended to overestimate the harms. Public Library of Science 2019-07-24 /pmc/articles/PMC6655768/ /pubmed/31339958 http://dx.doi.org/10.1371/journal.pone.0220148 Text en © 2019 Li et al http://creativecommons.org/licenses/by/4.0/ 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 author and source are credited.
spellingShingle Research Article
Li, Lin
Severens, J. L. (Hans)
Mandrik, Olena
Disutility associated with cancer screening programs: A systematic review
title Disutility associated with cancer screening programs: A systematic review
title_full Disutility associated with cancer screening programs: A systematic review
title_fullStr Disutility associated with cancer screening programs: A systematic review
title_full_unstemmed Disutility associated with cancer screening programs: A systematic review
title_short Disutility associated with cancer screening programs: A systematic review
title_sort disutility associated with cancer screening programs: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6655768/
https://www.ncbi.nlm.nih.gov/pubmed/31339958
http://dx.doi.org/10.1371/journal.pone.0220148
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