Quality of life measured by EQ-5D at different treatment time points for coronary artery disease: protocol for a systematic review and meta-analysis

INTRODUCTION: Cardiovascular disease is estimated to affect 423 million people globally. It caused 18 million deaths in 2017 and is projected to cost US$1 trillion by 2030 worldwide. Coronary artery disease (CAD) is the most common type of cardiovascular disease; CAD treatments can affect patients’ quality of life. Valuations of quality of life or health utilities are important for economic evaluations to ascertain relative health benefit when comparing treatments, and can be expected to change for individuals over time. The purpose of this systematic review is to estimate the quality of life of patients with CAD reported through the EuroQol 5 Dimension (EQ-5D) questionnaire, from short to longer term time points following different treatments. METHODS AND ANALYSIS: PubMed, Embase, Web of Science, the Cochrane Database of Systematic Reviews and the EuroQol website will be systematically searched from January 2003–March 2020. Published, peer-reviewed, English language studies assessing quality of life of patients with CAD using the EQ-5D will be included. One researcher will conduct the search; two researchers will independently screen titles and abstracts for potential inclusion. Full texts of potentially eligible studies will be retrieved for a second round of independent screening against inclusion and exclusion criteria by two researchers. The final list of included studies will be assessed for risk of bias using the RoB 2 and Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tools for randomised and non-randomised studies, respectively. Data extraction will be done by one researcher, with data extraction for a random 10% of included studies checked by a second researcher. Mean utility weights for individual studies will be combined using random effects model meta-analyses. A model will be run separately for each time point and treatment. Treatment time points of interest include baseline, 30 days, 6 months, 12–24 months and more than 24 months. Subgroup analysis of patients with diabetes who received interventional treatments—coronary artery bypass graft or percutaneous coronary intervention with or without stents, will be conducted for the same selected time points. ETHICS AND DISSEMINATION: Ethics approval is not required for systematic reviews. Results of the review will be disseminated via publication in a peer-reviewed journal.