Med Decis Making - Utility Values for Adults with Unipolar Depression: Systematic Review and Meta-Analysis.

Tópicos

{ state(1844) use(1261) util(961) }
{ studi(2440) review(1878) systemat(933) }
{ assess(1506) score(1403) qualiti(1306) }
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{ measur(2081) correl(1212) valu(896) }
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Resumo

CKGROUND: Unipolar depression is a mental illness with a substantial health-related and economic burden. Health interventions for depression predominately focus on improving sufferers' health-related quality of life (HRQoL). Utility is a measure of HRQoL that is required for use in model-based cost-utility analyses to assess the added value of health interventions. This review aimed to identify, summarize, and where feasible, synthesize published utilities for unipolar depression.METHODS: A structured electronic search combining common terms for unipolar depression and utility was conducted in MEDLINE, EMBASE, and PsycINFO. Utility values identified were summarized, and the study designs were appraised in terms of the patient population and valuation method used to generate utilities. Random-effect meta-analyses were applied to pool mean utilities identified for 3 depressive health states (mild, moderate, and severe) elicited from direct and indirect valuation methods separately.RESULTS: Thirty-five studies were identified that reported utilities for various levels of depression severity. The most commonly used direct valuation method for eliciting utilities was standard gamble (SG) (n = 5), and the most commonly used indirect valuation method was EQ-5D (n = 20). The pooled mean (standard deviation) utilities from studies using SG as a direct valuation method were mild = 0.69 (0.14), moderate = 0.52 (0.28), and severe = 0.27 (0.26). The pooled utilities from studies using EQ-5D as an indirect valuation method were mild = 0.56 (0.16), moderate = 0.45 (0.18), and severe = 0.25 (0.15).CONCLUSIONS: This systematic review is a useful resource for decision analysts who need health-related utility values to populate model-based cost-utility analyses of health interventions for the management of unipolar depression. Further research is necessary to understand whether direct or indirect valuation methods are the most robust sources for utilities in depression.

Resumo Limpo

ckground unipolar depress mental ill substanti healthrel econom burden health intervent depress predomin focus improv suffer healthrel qualiti life hrqol util measur hrqol requir use modelbas costutil analys assess ad valu health intervent review aim identifi summar feasibl synthes publish util unipolar depressionmethod structur electron search combin common term unipolar depress util conduct medlin embas psycinfo util valu identifi summar studi design apprais term patient popul valuat method use generat util randomeffect metaanalys appli pool mean util identifi depress health state mild moder sever elicit direct indirect valuat method separatelyresult thirtyf studi identifi report util various level depress sever common use direct valuat method elicit util standard gambl sg n common use indirect valuat method eqd n pool mean standard deviat util studi use sg direct valuat method mild moder sever pool util studi use eqd indirect valuat method mild moder sever conclus systemat review use resourc decis analyst need healthrel util valu popul modelbas costutil analys health intervent manag unipolar depress research necessari understand whether direct indirect valuat method robust sourc util depress

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