A systematic literature review of health state utility values in head and neck cancer

Abstract

BackgroundHealth state utility values (HSUVs) are essential parameters in model-based economic evaluations. This study systematically identifies HSUVs in head and neck cancer and provides guidance for selecting them from a growing body of health-related quality of life studies.MethodsWe systematically reviewed the published literature by searching PubMed, EMBASE and The Cochrane Library using a pre-defined combination of keywords. The Tufts Cost-Effectiveness Analysis Registry and the School of Health and Related Research Health Utilities Database (ScHARRHUD) specifically containing health utilities were also queried, in addition to the Health Economics Research Centre database of mapping studies. Studies were considered for inclusion if reporting original HSUVs assessed using established techniques. The characteristics of each study including country, design, sample size, cancer subsite addressed and demographics of responders were summarized narratively using a data extraction form. Quality scoring and critical appraisal of the included studies were performed based on published recommendations.ResultsOf a total 1048 records identified by the search, 28 studies qualified for data extraction and 346 unique HSUVs were retrieved from them. HSUVs were estimated using direct methods (e.g. standard gamble; n = 10 studies), multi-attribute utility instruments (MAUIs; n = 13) and mapping techniques (n = 3); two studies adopted both direct and indirect approaches. Within the MAUIs, the EuroQol 5-dimension questionnaire (EQ-5D) was the most frequently used (n = 11), followed by the Health Utility Index Mark 3 (HUI3; n = 2), the 15D (n = 2) and the Short Form-Six Dimension (SF-6D; n = 1). Different methods and types of responders (i.e. patients, healthy subjects, clinical experts) influenced the magnitude of HSUVs for comparable health states. Only one mapping study developed an original algorithm using head and neck cancer data. The identified studies were considered of intermediate quality.DiscussionThis review provides a dataset of HSUVs systematically retrieved from published studies in head and neck cancer. There is currently a lack of research for some disease phases including recurrent and metastatic cancer, and treatment-related complications. In selecting HSUVs for cost-effectiveness modeling purposes, preference should be given to EQ-5D utility values; however, mapping to EQ-5D is a potentially valuable technique that should be further developed in this cancer population.Electronic supplementary materialThe online version of this article (10.1186/s12955-017-0748-z) contains supplementary material, which is available to authorized users.

Cost-effectiveness analysis of proton beam therapy for treatment decision making in paranasal sinus and nasal cavity cancers in China

“…First, the HSUVs applied in our model were derived from previously published studies for head and neck cancer because of the lack of speci c HSUVs for paranasal sinus and nasal cavity cancer. As previously reported, the overall mean HSUV of head and neck cancer survivors after radiotherapy was consistently considered as 0.7 [25,26]. In this study, the survivors after radiotherapy had two different states, namely as "alive with cancer" and "no cancer".…”

Mapping the University of Washington Quality of life questionnaire onto EQ‐5D and HUI‐3 indices in patients with head and neck cancer

“…They reported Spearmen coefficients >0.6 between the UWQoL and EQ-5D measures of pain, activity, mood, and anxiety. 7 Of these, only three utilized mapping studies to predict health state utility values, and only Chan et al developed an original mapping algorithm. 23 They estimated a relationship through OLS regression and forward selection.…”

“…[24][25][26] A recent qualitative synthesis review paper by Meregaglia et al identified 28 articles concerned with cost-effective analysis of head and neck cancer treatment options. 7 Of these, only three utilized mapping studies to predict health state utility values, and only Chan et al developed an original mapping algorithm. 23 Meregaglia et al emphasize that additional research on mapping algorithms to convert disease-specific HRQoL results onto preference-based health state utility values would be of value in the population with HNC.…”

“…3 Current guidelines recommend the use of generic instruments (ie, a utility measure that can be used over a range of diseases) with community derived weights for measuring HU scores such as the EuroQol-5 Dimension (EQ-5D) 4 and Health Utility Index-Mark 3 (HUI-3). 7 In the absence of prospectively collected HU data, alternative approaches need to be considered. 7 In the absence of prospectively collected HU data, alternative approaches need to be considered.…”

“…1,5,6 That said, uptake of the EQ-5D and HUI-3 within HNC studies has been inconsistent, limiting the potential for health economic evaluation. 7 In the absence of prospectively collected HU data, alternative approaches need to be considered. One such approach is to establish a statistical association between prospectively collected HU data and data obtained from a condition specific instrument (in this case, one specific to patients with head and neck cancer).…”