Utility value estimates in cardiovascular disease and the effect of changing elicitation methods: a systematic literature review

• Published in: Health and quality of life outcomes 2020-07, Vol.18 (1), p.1-251, Article 251
• Main Authors: Betts, Marissa Blieden, Rane, Pratik, Bergrath, Evelien, Chitnis, Madhura, Bhutani, Mohit Kumar, Gulea, Claudia, Qian, Yi, Villa, Guillermo
• Format: Article
• Language: English
• Subjects: Analysis; Angina; Angina pectoris; Cardiovascular disease; Cardiovascular diseases; Cerebral infarction; Clinical trials; EQ-5D; Estimates; Health state utilities; Heart attack; Heart diseases; Identification methods; Keywords; Literature reviews; Medical research; Myocardial infarction; Population studies; Quality of life; Review; Stroke; Studies; Systematic review; Technology assessment; Trends; Utilities; Vascular diseases
• ISSN: 1477-7525; 1477-7525
• DOI: 10.1186/s12955-020-01407-y

Identify the most recent utility value estimates for cardiovascular disease (CVD) via systematic literature review (SLR) and explore trends in utility elicitation methods in the last 6 years. This SLR was updated on January 25, 2018, and identified studies reporting utilities for myocardial infarction (MI), stroke, angina, peripheral artery disease (PAD), and any-cause revascularization by searching Embase, PubMed, Health Technology Assessment Database, and grey literature. A total of 375 studies reported CVD utilities (pre-2013 vs post-2013: MI, 38 vs 32; stroke, 86 vs 113; stable angina, 8 vs 9; undefined/unstable angina, 23 vs 8; PAD, 29 vs 13; revascularization, 54 vs 40). Median average utilities for MI, stroke, and revascularization increased over time (pre-2013 vs post-2013: MI, 0.71 vs 0.79; stroke, 0.63 vs 0.64; revascularization, 0.76 vs 0.81); angina and PAD showed a decrease in median values over time (stable angina, 0.83 vs 0.72; undefined/unstable angina, 0.70 vs 0.69; PAD, 0.76 vs 0.71). The proportion of utility estimates from trials increased across health states (pre-2013 vs post-2013: 22.5% vs 37.2%), as did the proportion of trials using the EuroQol Five Dimensions Questionnaire (EQ-5D; pre-2013 vs post-2013: 73.8% vs 91.4%). Use of methods such as the standard gamble, time trade-off, and Health Utilities Index has declined. Health state utilities for cardiovascular health states have changed in the last 6 years, likely due to changes in the types of studies conducted, the patient populations evaluated, and possibly changing utility elicitation methods. The EQ-5D has been used more frequently.