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Multivariate Meta-Analysis of Preference-Based Quality of Life Values in Coronary Heart Disease

Multivariate Meta-Analysis of Preference-Based Quality of Life Values in Coronary Heart Disease

Authors :
J. Stevanovic
Paul F M Krabbe
Marthe A. Kampinga
Maarten J. Postma
Petros Pechlivanoglou
Microbes in Health and Disease (MHD)
PharmacoTherapy, -Epidemiology and -Economics
Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)
Value, Affordability and Sustainability (VALUE)
Source :
PLoS ONE, PLoS ONE, 11(3):e0152030. PUBLIC LIBRARY SCIENCE, PLoS ONE, Vol 11, Iss 3, p e0152030 (2016)
Publication Year :
2016
Publisher :
PUBLIC LIBRARY SCIENCE, 2016.

Abstract

BackgroundThere are numerous health-related quality of life (HRQol) measurements used in coronary heart disease (CHD) in the literature. However, only values assessed with preference-based instruments can be directly applied in a cost-utility analysis (CUA).ObjectiveTo summarize and synthesize instrument-specific preference-based values in CHD and the underlying disease-subgroups, stable angina and post-acute coronary syndrome (post-ACS), for developed countries, while accounting for study-level characteristics, and within- and between-study correlation.MethodsA systematic review was conducted to identify studies reporting preference-based values in CHD. A multivariate meta-analysis was applied to synthesize the HRQoL values. Meta-regression analyses examined the effect of study level covariates age, publication year, prevalence of diabetes and gender.ResultsA total of 40 studies providing preference-based values were detected. Synthesized estimates of HRQoL in post-ACS ranged from 0.64 (Quality of Well-Being) to 0.92 (EuroQol European"tariff"), while in stable angina they ranged from 0.64 (Short form 6D) to 0.89 (Standard Gamble). Similar findings were observed in estimates applying to general CHD. No significant improvement in model fit was found after adjusting for study-level covariates. Large between-study heterogeneity was observed in all the models investigated.ConclusionsThe main finding of our study is the presence of large heterogeneity both within and between instrument-specific HRQoL values. Current economic models in CHD ignore this between-study heterogeneity. Multivariate meta-analysis can quantify this heterogeneity and offers the means for uncertainty around HRQoL values to be translated to uncertainty in CUAs.

Details

Language :
English
ISSN :
19326203
Volume :
11
Issue :
3
Database :
OpenAIRE
Journal :
PLOS-One
Accession number :
edsair.doi.dedup.....02235802212a5294ff22cac0bae6527f
Full Text :
https://doi.org/10.1371/journal.pone.0152030