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...
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| Format: | Article |
| Language: | English |
| Published: |
BioMed Central
2016
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| Subjects: | |
| Online Access: | http://repository.vnu.edu.vn/handle/VNU_123/11432 |
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| Institution: | Vietnam National University, Hanoi |
| Language: | English |
| Summary: | 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 |
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