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Wiley InterScience

Value in Health

Value in Health

Volume 11 Issue 4, Pages 733 - 741

Published Online: 8 Jan 2008

© 2010 International Society for Pharmacoeconomics and Outcomes Research



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Preference-Based Quality of Life of Patients on Renal Replacement Therapy: A Systematic Review and Meta-Analysis
Ylian S. Liem, MD, MSc, 1,2 Johanna L. Bosch, PhD, 1 M. G. Myriam Hunink, MD, PhD 1,3
  1 Assessment of Radiological Technology Program (ART Program), Department of Epidemiology and Biostatistics and   2 Department of Radiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands;   3 Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA
Correspondence to  M. G. Myriam Hunink, Assessment of Radiological Technology (ART) Program, Department of Epidemiology and Biostatistics, Erasmus University Medical Center Rotterdam; Room EE21-40a, Dr. Molewaterplein 50; 3015 GE Rotterdam, The Netherlands. E-mail: m.hunink@erasmusmc.nl
Copyright © 2008 International Society for Pharmacoeconomics and Outcomes Research (ISPOR)
KEYWORDS
hemodialysis • meta-analysis • peritoneal dialysis • quality of life • renal transplantation

ABSTRACT

Objectives: Various utility measures have been used to assess preference-based quality of life of patients with end-stage renal disease (ESRD). The purposes of this study were to summarize the literature on utilities of hemodialysis (HD), peritoneal dialysis (PD), and renal transplantation (RTx) patients, to compare utilities between these patient groups, and to obtain estimates for quality-of-life adjustment in economic analyses.

Methods: We searched the English literature for studies that reported visual analog scale (VAS), time trade-off (TTO), standard gamble (SG), EuroQol-5D (EQ-5D), and health utilities index (HUI) values of ESRD patients. We extracted patient characteristics and utilities and calculated mean utilities and 95% confidence intervals (CIs) for categories defined by utility measure and treatment modality using random-effects models.

Results: We identified 27 articles that met the inclusion criteria. VAS articles were too heterogeneous to summarize quantitatively and we found only one study reporting HUI values. Thus, we summarized utilities from TTO, SG, and EQ-5D studies. Mean TTO and EQ-5D-index values were lower for dialysis compared to RTx patients, though not statistically significant for TTO values (TTO values: HD 0.61, 95% CI 0.54–0.68; PD 0.73, 95% CI 0.61–0.85; RTx 0.78, 95% CI 0.63–0.93; EQ-5D-index values: HD 0.56, 95% CI 0.49–0.62; PD 0.58, 95% CI 0.50–0.67; RTx 0.81, 95% CI 0.72–0.90). Mean HD versus PD associated TTO, EQ-5D-index and EQ-VAS values were not statistically significantly different.

Conclusion: RTx patients tended to have a higher utility than dialysis patients. Among HD and PD patients, there were no statistically significant differences in utility.


DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1524-4733.2007.00308.x About DOI

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