Αρχειοθήκη ιστολογίου

Παρασκευή 27 Οκτωβρίου 2017

A systematic review and meta-analysis of utility estimates in melanoma

Summary

We sought to determine pooled estimates of utility-based health-related quality-of-life (HRQOL) (utilities) for people with American Joint Cancer Committee stage I/II, III, IV melanoma for use in economic evaluations.

We performed a systematic review, meta-analysis, and meta-regression of utilities for melanoma patients. HRQOL scores reported with QLQ-C30, SF-36, SF-12, FACT-G, and FACT-M instruments were converted to utilities using published mapping algorithms. Meta-analysis was used to calculate mean utilities. Meta-regression examined the effects of baseline patient and study characteristics.

We identified 33 studies reporting 213 utilities. From meta-analyses, the mean utility for stage I/II melanoma was 0.970 (95%CI: 0.895-0.979); for stage III melanoma was 0.766 (95%CI: 0.699-0.833); for stage III/IV was 0.763 (95%CI: 0.755-0.771) and for stage IV melanoma was 0.764 (95%CI: 0.714-0.813). The difference in utility between stage III and stage IV was not statistically significant (p=0.521). For patients with stage I/II, the utility estimate at time of surgery was 0.772 (95%CI: 0.753-0.790), and from 3-12 months post-surgery, the utility estimate was 0.852 (95%CI: 0.844-0.860). Utility estimates for patients with stage IV melanoma were 0.653 (95%CI: 0.621-0.685) during the first 3 months of treatment and 0.831 (95%CI: 0.808-0.855) from 4-12 months on treatment. For patients with stage IV melanoma treated with chemotherapy, the utility estimate was 0.518 (95%CI: 0.513-0.523), while for those treated with targeted therapy, the utility estimate was 0.834 (95%CI: 0.822-0.846).

These robust, evidence-based estimates of health state utility can be used in economic evaluations of new treatments for patients with early stage or advanced stage melanoma.

This article is protected by copyright. All rights reserved.



http://ift.tt/2zLXGTM

Δεν υπάρχουν σχόλια:

Δημοσίευση σχολίου