A systematic literature review of cardiovascular event utilities

Smith, Donald W.; Davies, Evan; Wissinger, Erika; Huelin, Rachel; Matza, Louis S.; Chung, Karen

doi:10.1586/14737167.2013.841545

Cited by 14 publications

(12 citation statements)

References 116 publications

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“…The lower utility score of 0.33 for the year including a stroke (health state A) is similar to relatively low values reported by two previous studies assessing utility with the EQ-5D at time points during the first year after a stroke, ranging from 0.21 to 0.41 [ 30 , 32 ]. In addition, the lower utility for acute stroke than for chronic stroke (difference = 0.20) is consistent with the findings of a recent review, which noted that EQ-5D scores tend to improve over time following a stroke [ 27 ]. However, some contrasting results have also been reported, including those from two studies with relatively high utility values during the first year after a stroke [ 31 , 34 ].…”

Section: Discussionsupporting

confidence: 87%

“…A CUA requires health state utility values, which represent the strength of preferences for various health states and are used to calculate quality-adjusted life years (QALYs) [ 24 - 26 ]. A recent systematic review found that a wide range of published utility values are available to represent health states with cardiovascular conditions such as stroke, acute coronary syndrome (ACS), and heart failure [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute and chronic impact of cardiovascular events on health state utilities

Matza¹,

Stewart²,

Gandra

et al. 2015

BMC Health Serv Res

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BackgroundCost-utility models are frequently used to compare treatments intended to prevent or delay the onset of cardiovascular events. Most published utilities represent post-event health states without incorporating the disutility of the event or reporting the time between the event and utility assessment. Therefore, this study estimated health state utilities representing cardiovascular conditions while distinguishing between acute impact including the cardiovascular event and the chronic post-event impact.MethodsHealth states were drafted and refined based on literature review, clinician interviews, and a pilot study. Three cardiovascular conditions were described: stroke, acute coronary syndrome (ACS), and heart failure. One-year acute health states represented the event and its immediate impact, and post-event health states represented chronic impact. UK general population respondents valued the health states in time trade-off tasks with time horizons of one year for acute states and ten years for chronic states.ResultsA total of 200 participants completed interviews (55% female; mean age = 46.6 y). Among acute health states, stroke had the lowest utility (0.33), followed by heart failure (0.60) and ACS (0.67). Utility scores for chronic health states followed the same pattern: stroke (0.52), heart failure (0.57), and ACS (0.82). For stroke and ACS, acute utilities were significantly lower than chronic post-event utilities (difference = 0.20 and 0.15, respectively; both p < 0.0001).ConclusionsResults add to previously published utilities for cardiovascular events by distinguishing between chronic post-event health states and acute health states that include the event and its immediate impact. Findings suggest that acute versus chronic impact should be considered when selecting scores for use in cost-utility models. Thus, the current utilities provide a unique option that may be used to represent the acute and chronic impact of cardiovascular conditions in economic models comparing treatments that may delay or prevent the onset of cardiovascular events.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0772-9) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Acute and chronic impact of cardiovascular events on health state utilities

Matza¹,

Stewart²,

Gandra

et al. 2015

BMC Health Serv Res

Self Cite

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“…The current study adds to this research by demonstrating that awareness of elevated risk of these medical conditions, rather than the conditions themselves, may also have a measurable impact on utility. As expected, the disutility of risk (health states 2 to 4) was smaller than the disutility of the medical conditions represented by health states 5 to 8 and quantified in previous research [55–61]. However, the relatively small disutilities associated with ART risks, ranging from 0.018 to 0.049 (Table 5), could still have an impact on the outcomes of a cost-utility model comparing treatments that differ in terms of these risks.…”

Section: Discussionsupporting

confidence: 79%

“…Previous studies have consistently demonstrated that health state utilities are significantly reduced as a result of bone problems [55, 56], renal disease [57–59], and cardiovascular disease [60, 61]. The current study adds to this research by demonstrating that awareness of elevated risk of these medical conditions, rather than the conditions themselves, may also have a measurable impact on utility.…”

Section: Discussionmentioning

confidence: 52%

Risks associated with antiretroviral treatment for human immunodeficiency virus (HIV): qualitative analysis of social media data and health state utility valuation

Matza¹,

Chung

Kim

et al. 2017

Qual Life Res

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PurposeDespite benefits of antiretroviral therapies (ART), people with HIV infection have increased risk of cardiovascular disease, kidney disease, and low bone mineral density. Some ARTs increase risk of these events. The purpose of this study was to examine patients’ perspectives of these risks and estimate health state utilities associated with these risks for use in cost-utility models.MethodsQualitative thematic analysis was conducted to examine messages posted to the POZ/AIDSmeds Internet community forums, focusing on bone, kidney, and cardiovascular side effects and risks of HIV/AIDS medications. Then, health state vignettes were drafted based on this qualitative analysis, literature review, and clinician interviews. The health states (representing HIV, plus treatment-related risks) were valued in time trade-off interviews with general population participants in the UK.ResultsQualitative analysis of the Internet forums documented patient concerns about ART risks, as well as treatment decisions made because of these risks. A total of 208 participants completed utility interviews (51.4% female; mean age 44.6 years). The mean utility of the HIV health state (virologically suppressed, treated with ART) was 0.86. Adding a description of risk resulted in statistically significant disutility (i.e., utility decreases): renal risk (disutility = −0.02), bone risk (−0.03), and myocardial infarction risk (−0.05).ConclusionsPatient concerns and treatment decisions were documented via qualitative analysis of Internet forum discussions, and the impact of these concerns was quantified in terms of health state utilities. The resulting disutilities may be useful for differentiating among ARTs in economic modeling of treatment for patients with HIV.

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“…Previous cost-utility analyses of treatments for CKD and SHPT have used utilities for cardiovascular events and fractures from outside of the context of CKD due to the lack of utility data available for these events in this population [ 30 – 33 ]. However, the literature for cardiovascular events is highly variable [ 58 ], making it difficult to select the appropriate values for use in a model focusing on treatment of CKD. In addition, the majority of utilities for fractures have come from utility estimates in osteoporosis, which may not be relevant to patients with CKD [ 30 – 33 ].…”

Section: Discussionmentioning

confidence: 99%

Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis

Davies

Matza²,

Worth

et al. 2015

Health Qual Life Outcomes

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BackgroundPatients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT) who require dialysis are at increased risk for cardiovascular events and bone fractures. To assist in economic evaluations, this study aimed to estimate the disutility of these events beyond the impact of CKD and SHPT.MethodsA basic one-year health state was developed describing CKD and SHPT requiring dialysis. Further health states added acute events (cardiovascular events, fractures, and surgical procedures) or chronic post-event effects. Acute health states described a year including an event, and chronic health states described a year subsequent to an event. General population participants in Canada completed time trade-off interviews from which utilities were derived. Pairwise comparisons were made between the basic state and event, and between comparable health states.ResultsA total of 199 participants (54.8% female; mean age = 46.3 years) completed interviews. Each health state had ≥130 valuations. The mean (SD) utility of the basic health state was 0.60 (0.34). For acute events, mean utility differences versus the basic state were: myocardial infarction, −0.06; unstable angina, −0.05; peripheral vascular disease (PVD) with amputation, −0.33; PVD without amputation, −0.11; heart failure, −0.14; stroke, −0.30; hip fracture, −0.14; arm fracture, −0.04; parathyroidectomy, +0.02; kidney transplant, +0.06. Disutilities for chronic health states were: stable angina, −0.09; stroke, −0.27; PVD with amputation, −0.30; PVD without amputation, −0.12; heart failure, −0.14.ConclusionsCardiovascular events and fractures were associated with lower utility scores, suggesting a perceived decrease in quality of life beyond the impact of CKD and SHPT.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-015-0266-9) contains supplementary material, which is available to authorized users.

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A systematic literature review of cardiovascular event utilities

Cited by 14 publications

References 116 publications

Acute and chronic impact of cardiovascular events on health state utilities

Acute and chronic impact of cardiovascular events on health state utilities

Risks associated with antiretroviral treatment for human immunodeficiency virus (HIV): qualitative analysis of social media data and health state utility valuation

Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis

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