Time-trade off and standard gamble utilities in psoriasis: a systematic literature review and meta-analysis

Absztrakt (kivonat)

Objective: This study aims to review the current literature on time trade-off (TTO) and standard gamble (SG) in psoriasis and to catalogue all the reported utility values within these studies. Introduction: Psoriasis is a chronic disease that can negatively impact the quality of life of patients. The direct utility measures (TTO and SG) allow for quantification of the utility and consider the preferences of the patient or the public. Methods: A systematic literature review was conducted on Web of Science, PubMed, and Cochrane library from 30 October 2021 to 8 November 2021. The following inclusion criteria were used: (1) the articles must be original studies, (2) the articles must be published in English, (3) the articles must report utilities measured by TTO, or SG (4) the articles must be about psoriasis. A random effect (REML) meta-analysis was done for the TTO values, the patient’s own health state and the different severity levels (mild, moderate, and severe) of the hypothetical health states were analysed separately. The overall effect size and CI was calculated in each meta-analysis. Results: The initial search found 671 articles. The duplicates were removed and then the articles were filtered by title and abstract. Then the full text articles were screened. There was a manual search, and an additional article was found. The final number of relevant articles that were included for further analysis was 11. Data pertaining to study characteristics, TTO and SG characteristics and the reported utility values (mean, standard deviation, median, and interquartile range) were extracted from the studies. All the included studies reported TTO utility values. In addition, four of these also reported SG utility values. The timeframe, iteration process and health state description differ between studies. The overall effect size (CI; I2) of the mild hypothetical health state was 0.87 (0.85-0.90; 77.96). The moderate hypothetical health state the overall effect size was 0.785 (0.73-0.83; 94.21). The overall effect size was 0.66 (0.54-0.79;0.79) in the severe hypothetical health state. And lastly, the patient’s own health state had an overall effect size of 0.85 (0.81-0.89; 91.73). Conclusion: This is the first review to summarise and analyse the direct utility values reported for psoriasis. The methods used to generate the TTO utility values varied greatly whereas the SG methods were more homogenous. Time trade-off was more commonly used than SG. Meta-analysis revealed that the patient’s own health pooled utility value was higher than the moderate and severe hypothetical health states. There was considerable heterogeneity in all the meta-analyses.