Published: 03-02-2020

We update the heoro.com database every day with new studies relevant to health economics and outcomes research. In this blog we summarise some of the key studies added throughout February 2020.

Studies reporting utilities

• EQ-5D and Cystic Fibrosis Questionnaire-Revised scores were significantly better in patients with G551D mutation who were taking ivacaftor than in those homozygous for F508del receiving usual care before lumacaftor/ivacaftor were available. Bell 2019 Go to paper on PubMed
• SF-36 and McGill Pain Questionnaire (MPQ) scores showed that patients in Brazil with fibromyalgia and chronic non-specific low back pain had higher pain scores than patients with knee osteoarthritis but similar quality of life. De Oliveira Paes Leme 2019 Go to paper on PubMed
• Health state utilities were derived for people with chronic hepatitis B in Vietnam, using 4 preference- and non-preference-based instruments including the EQ-5D. Tran 2019 Go to paper on PubMed
• A Portuguese value set was developed for the EQ-5D-5L using time trade-off and discrete choice experiments, giving a range of values from -0.603 to 1. Ferreira 2019 Go to paper on PubMed
• The EQ-5D and SF-6D were strongly correlated but EQ-5D was more responsive to change in older adults undergoing a falls prevention intervention in Norway. Bjerk 2019 Go to paper on PubMed
• A systematic review was used to develop a catalogue of EQ-5D scores in chronic diseases compared with the general population, with a range from -0.20 to 1. Van Wilder 2019 Go to paper on PubMed
• The EORTC QLQ-C30 was mapped to the EQ-5D-5L and EQ-5D-3L in patients receiving brigatinib for non-small-cell lung cancer in the USA; utilities increased from 0.60 to 0.71 at baseline to 0.78 by cycle 5. Kawata 2019 Go to paper on PubMed
• The Psoriasis Area Severity Index (PASI) was mapped to utilities in psoriasis by time trade-off with the UK general population; utilities were more strongly associated with PASI scores for head and upper limb than total or trunk/ lower limb scores. Matza 2019 Go to paper on PubMed
• EQ-5D values increased by 0.156 points from a mean 0.581 in people with primary headache in the UK after vagus nerve stimulation with Gammacore; GP visits fell by 28.5% over 40 weeks. Strickland 2018 Go to paper on PubMed
• A systematic review found that SF-36 MCS scores improved with nursing interventions such as case  management in people with chronic disease but other subscales were not significantly different. Amo-Setien 2019 Go to paper on PubMed
• Time trade-off utilities from the UK general population were 0.78 to 0.79 for joint and spine surgery without infection; disutilities were -0.03 to -0.32 for Staph aureus wound infections depending on severity and need for intervention. Matza 2019 Go to paper on PubMed
• Normative EQ-5D-5L values were determined for the German population based on a representative sample, mean value was 0.88 (SD 0.18). Grochtdreis 2019 Go to paper on PubMed
• SF-36 scores were lower and stress, anxiety and depression higher in women at increased risk of ovarian cancer who chose risk-reducing salpingo-oophorectomy compared with ovarian cancer screening, but improved over 60 months. Mai 2020 Go to paper on PubMed
• Health state time trade-off utilities in acute myeloid leukaemia in the UK ranged from -0.21 during stem cell transplantation to 0.94 after transplantation. Joshi 2019 Go to paper on PubMed

Studies validating a PRO instrument

•  The estimated minimally important difference in tools assessing anxiety in US patients with musculoskeletal disorders was 4 for the PROMIS scales; 3 for the GAD-7; 6 for the PCL; 9 for the SF-36 mental health subscale; 5 for the MCS score, and 0.3 for the SCL anxiety scale. Kroenke 2019 Go to paper on PubMed
• The Anti-Clot Treatment Scale (ACTS) and Treatment Satisfaction Questionnaire for Medication version II (TSQM-II) have been validated in patients taking rivaroxaban for atrial fibrillation in Japan. Watanabe-Fujinuma 2019 Go to paper on PubMed
• The Oropharyngeal Mucositis-Specific Quality-of-Life instrument (OMQoL) was validated against the PedsQL in children with oropharyngeal mucositis following cancer treatment in Mexico. Gutierrez-Vargas 2019 Go to paper on PubMed
• The Migraine-Specific Quality of Life Questionnaire (MSQ) and the Headache Impact Test (HIT-6) were mapped to the EQ-5D in patients with migraine taking erenumab. Di Tanna 2019 Go to paper on PubMed
• A systematic review concluded that the SF-36 is a reliable tool to assess improvement after surgery in degenerative cervical myelopathy compared with the modified Japanese Orthopedics Association (JOA) and Neck Disability Index (NDI) scores. Wang 2019 Go to paper on PubMed
• A systematic review concluded that the QOL-OC was the tool with the best COSMIN measurement properties to assess quality of life in oral cancer. Gondivkar 2019 Go to paper on PubMed
• Minimally important differences were established for the EORTC-QLQ-MY20 for patients with multiple myeloma; MIDs ranged from 6 to 33 points across subscales. Sully 2019 Go to paper on PubMed
• A systematic review concluded that the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) and the Ardouin Scale of Behavior in Parkinson's Disease (ASBPD) were the most reliable tools to assess impulse control disorders in Parkinson's disease. Izzo 2019 Go to paper on PubMed
• The Pressure ulcer quality of life instrument-prevention version (PU-QOL-P) was more responsive at detecting disease severity than the SF12 in patients with pressure ulcers. Rutherford 2019 Go to paper on PubMed 
• The updated Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity Computer Adaptive Test (UE CAT) was validated against the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) in patients with non-shoulder upper extremity disorders in the USA. Tyser 2019 Go to paper on PubMed
• The Zurich chronic middle ear inventory (ZCMEI-21) was validated against the EQ-5D in adults with chronic otitis media in Italy. Ralli 2019 Go to paper on PubMed

Other PRO studies

• Patients in the Netherlands with bone metastases who responded to palliative radiotherapy had improvement in pain scores for 56.6% of their remaining lives on average; missing questionnaire responses mean this value could range from 36% to 62%. Spencer 2019 Go to paper on PubMed
• Quality of life, on the General Health Questionnaire (GHQ), Self-Rated Health (SRH) and MacNew QLMI questionnaires, was significantly better in patients who received cardiac rehabilitation compared with usual care after myocardial infarction in Pakistan. Il-Haq 2019 Go to paper on PubMed
• 6 months after radical prostatectomy in Italy, 67 to 79% of men need no pad for urinary loss, 16 to 40% can achieve adequate erections; scores higher after robotic than open prostatectomy. Antonelli 2019 Go to paper on PubMed
• Improvement in NEI VFQ-39 scores were similar in patients with Fuch's endothelial dystrophy or pseudophakic bullous keratopathy undergoing Descemet membrane endothelial keratoplasty (DMEK) or ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) in the USA. Ang 2019 Go to paper on PubMed

Studies reporting costs and resource use

• Increased nurse productivity in preparing patients for discharge was significantly associated with a 0.48% lower risk of 30-day readmission and 0.29% reduction in ED visits in the USA. Yakusheva 2019 Go to paper on PubMed
• Golimumab or infliximab therapy reduced hospitalisations, out-patient and emergency department visits and increased work productivity over 6 months in patients with ankylosing spondylitis. Claudepierre 2019 Go to paper on PubMed
• Costs of index hospitalisation in the USA were significantly higher in patients who quit smoking 6 months after admission than in those who continued to smoke; mean 6-month follow-up costs and resource use were similar in quitters and smokers. Nolan 2019 Go to paper on PubMed
• A systematic review found that the mean weighted cost of ART therapy in Africa was $251 per patient with HIV; 46% drug costs, 31% personnel costs, 20% other recurrent costs, 2% capital costs in 2017 US$. Cerecero-Garcia 2019 Go to paper on PubMed
• Healthcare costs were 5.4 times higher than control patients 5 years before a diagnosis of schizophrenia in the USA in 2007 to 2016, and 14.8 times higher in the year before diagnosis. Wallace 2019 Go to paper on PubMed
• Decreasing smoking prevalence by 1% in Medicaid enrollees would have saved $2.6 billion from Medicaid spending in 2018 overall, a median saving of £25 million per state per year. Glantz 2019 Go to paper on PubMed
• Median direct medical costs for early operable breast cancer in France were €12,250 in the first year after diagnosis; median sick leave costs were €3,687/yr without chemotherapy versus €10,706/yr with chemotherapy. Hequet 2019 Go to paper on PubMed
• The total cost of incorrect application of anticoagulant bridging protocol for 161 patients with atrial fibrillation about to undergo minor surgical procedures in Spain was €11,445. Cuevas 2019 Go to paper on PubMed
• Monthly healthcare costs of people with severe aplastic anaemia in the USA were $28,280 overall and $7,884 for aplastic anaemia-related direct costs. Cai 2019 Go to paper on PubMed
• Same-day access to an academic ophthalmology department reduces costs and length of visit compared with attending an emergency department for urgent eye problems in the USA. Singman 2019 Go to paper on PubMed
• Informal caregiver time was mapped to EQ-5D scores in the Netherlands and ranged from 13.06 hr/week for female patients with no health problems but receiving informal care to 52.82 h/wk for male patients with highest level of problems on all EQ-5D dimensions. Gheorghe 2019 Go to paper on PubMed

Economic evaluations

• Molecular testing as an adjunct to blood cultures is cost-saving in severe sepsis or septic shock in the USA where the increased length of stay due to inappropriate antibiotic prescribing is 4 days, and is cost-effective at lower LOS differences, with an ICER of <$20,000/death averted. Zacharioudakis 2019 Go to paper on PubMed
• Peripheral trigger site deactivation surgery has lower costs over 6.75 years and greater effectiveness at preventing refractory migraine than onabotulinumtoxin A injections in the USA. Schoenbrunner 2020 Go to paper on PubMed
• Internet-based CBT is cost-effective in adolescents with irritable bowel syndrome in Sweden, with an ICER of US$54,916/QALY gained and $85.29/point improvement in PedsQL score. Sampaio 2019 Go to paper on PubMed
• Neratinib is unlikely to be cost-effective after adjuvant trastuzumab in early HER2-positive breast cancer in the USA, with an ICER of $416,106/QALY gained overall and $275,311/QALY in hormone receptor-positive disease. Schwartz 2019 Go to paper on PubMed
• Use of direct-acting antivirals is cost-effective in all people diagnosed with hepatitis C in India, with an ICER of US$1586/QALY, and is cost-saving in people with F2 to F4 fibrosis and 1% to 15% reinfection/yr. Chaillon 2019 Go to paper on PubMed
• Adjuvant paclitaxel and trastuzumab is cost-effective in early-stage, node-negative, HER2-positive breast cancer in the USA, with a societal ICER of $10,584 for women aged 40 to 49yr to $84,981 for ages 80+ compared with no adjuvant trastuzumab. Hajjar 2019 Go to paper on PubMed
• Noninvasive vagus nerve stimulation with Gammacore was cheaper than standard care with higher QALYs in episodic migraine in the USA and reduced the need for erenumab prevention. Mwamburi 2018 Go to paper on PubMed
• Ixekizumab has the lowest cost per number-needed-to-treat to achieve PASI-75, -90 or -100 response in moderate-severe plaque psoriasis in Spain. Nunez 2019 Go to paper on PubMed
• A systematic review found that most treatment options for obstructive sleep apnoea had a positive economic impact; cost-effectiveness depends on treatment adherence and OSA severity. Wickwire 2019 Go to paper on PubMed
• Edoxaban is more cost-effective than dalteparin for treating cancer-associated thrombosis in the USA; the ICER for dalteparin versus edoxaban was $1,873,535/QALY gained in the general oncology population and $694,058/QALY in gastrointestinal cancers. Connell 2019 Go to paper on PubMed
• Semaglutide has greater health benefits and lower costs than dulaglutide in patients with type 2 diabetes in Sweden who are uncontrolled on metformin, and also dominates lixisenatide in patients uncontrolled on basal insulin. Ericsson 2019 Go to paper on PubMed
• Add-on ipragliflozin was cost-effective compared with pioglitazone (ICER =$4977/1% change in HbA1c) and with sitagliptin plus metformin (ICER= $2090/1% chnage in HbA1c) in type 2 diabetes in China. Wang 2019 Go to paper on PubMed

Studies reporting mortality rates and trends

• Conducting radical cystectomy for bladder cancer at a low-volume hospital was associated with a 66% higher relative increase in hazard of death at 30 days and 33% higher hazard at 90 days compared with high volume centres in the USA in 2004 to 2013. Waingankar 2019 Go to paper on PubMed
• In people receiving opioid agonists such as methadone in the UK, co-prescription of benzodiazepines and z-drugs prolonged opioid treatment and increased mortality from drug-related poisoning 2- to 3-fold. Macleod 2019 Go to paper on PubMed
• Crude overall and neurologically-intact survival 1month after out-of-hospital cardiac arrest was higher in men than women in most 10-year age groups in Japan 2013 to 2016, the difference was not significant after propensity score matching. Goto 2019 Go to paper on PubMed
• 30-day mortality was 10% in patients admitted with acute heart failure in Spain; underlying acute coronary syndrome increased the risk of mortality, underlying atrial fibrillation and hypertension reduced the risk. Rossello 2019 Go to paper on PubMed
• In-hospital mortality was 15.14% in adults admitted with Stevens-Johnson syndrome/toxic epidermal necrolysis in the USA in 2016-2018; the ABCD-10 score predicted risk. Noe 2019 Go to paper on PubMed
• In the USA in 2005 to 2015, an extra 10 primary care physicians per 100,000 population was associated with a 51.5-day increase in life expectancy, 10 more specialist physicians/100,000 were associated with a 19.2-day increase in life expectancy. Basu 2019 Go to paper on PubMed
• The SOFA and APACHE II scores were more accurate than SIRS at predicting 28-day mortality in adults admitted with severe acute respiratory infections in Turkey. Aydin 2019 Go to paper on PubMed
• Mortality from cirrhosis in the USA decreased from 11.9/100 person-years in 2004 to 10.0/100 person-years in 2014: 6.4/100 P-Y in those 65 yrs. Orman 2019 Go to paper on PubMed
• Median overall survival in HCV-related hepatocellular carcinoma in Korea was 28.6 months; 15 months with HCV genotype 3, 28.7 months with genotype 1, 31.7 months with genotype 2. Park 2019 Go to paper on PubMed