Published: 01-10-2019

The heoro.com database is updated daily from a systematic search of PubMed for studies relevant to health economics and outcomes research.

In this blog we summarise some of the most important and interesting studies added throughout the month of October 2019.

Studies reporting utilities

• EQ-5D utility values increased after cardiac surgery in frail elderly patients in Spain.  Miguelena-Hycka 2019 Go to paper on PubMed
• Presenteeism, reported by 77% of adults in Japan with chronic low back pain, is associated with lower SF-36 MCS and PCS scores. Tsuji 2018 Go to paper on PubMed
• SF-36 PCS and MCS scores were lower after prolonged (3 days or more) ICU stay compared with shorter stay but recovered by 12 months; length of hospital admission and mortality were also higher. Diab 2018 Go to paper on PubMed
• EQ-5D-3L utility values were determined for head and neck cancer health states in France; the main drivers are age, comorbidity and time since response. Schwarzinger 2019 Go to paper on PubMed
• Mean SF-36 PCS and MCS scores are low in people with multidrug-resistant TB in Yemen even 1 year after treatment, especially in those with longer duration of illness before treatment. Jaber 2019 Go to paper on PubMed 
• Utility values were determined using the EQ-5D and Functional Assessment of Cancer Therapy-Prostate (FACT-P) for patients with prostate cancer in Japan, stratified by disease progression. Murasawa 2019 Go to paper on PubMed
• Time-trade-off studies in the general UK population were used to determine utility values for migraine and preventive treatments. Matza 2019 Go to paper on PubMed

Studies validating a PRO instrument

• The Study of Osteoporotic Fractures (SOF) tool was better than the Cardiovascular Health Study (CHS) tool at identifying frailty in elderly patients undergoing CABG or heart valve surgery in the USA. Henry 2019 Go to paper on PubMed
• The Menopause-Specific Quality of Life (MENQOL) questionnaire was mapped to the EQ-5D in postmenopausal women experiencing side effects from hormone replacement therapy. Coon 2018 Go to paper on PubMed
• The Kurdish Vertigo Symptom Scale-Short Form (VSS - SF) was validated in adults in Iraq with vestibular symptoms. Zmnako 2019 Go to paper on PubMed
• The Breast Pain and Tenderness Daily Diary (BPT-DD) and the Vaginal Bleeding and Spotting Daily Diary (VBS-DD) were validated as measures of adverse effects of hormone replacement therapy in postmenopausal women. Tatlock 2018 Go to paper on PubMed
• The Developmental Trauma Disorder Semi-Structured Interview was validated against the Kiddie Schedule for Affective Disorders and Schizophrenia and Child Behavior Checklist in children with developmental trauma disorder in the USA. Ford 2018 Go to paper on PubMed
• The Psychosocial impact of dental aesthetics questionnaire (PIDAQ) was validated against the Index of orthodontic treatment need-aesthetic component (IOTN-AC) and the perception of occlusion index in adults requiring orthodontic treatment in Iran. Naseri 2019 Go to paper on PubMed
• A systematic review found that the Patient-Reported Outcomes Measurement Information System correlates with most PRO instruments used in spinal surgery, including the Neck Disability Index. Haws 2019 Go to paper on PubMed
• The National Eye Institute Visual Function Questionnaire (NEI-VFQ 25) was validated against the EQ-5D and Patient acceptable symptom state (PASS 5) in people receiving anti-VEGF injections for neovascular age-related macular degeneration in Norway. Jelin 2019 Go to paper on PubMed
• The Integrated Palliative care Outcome Scale (IPOS) was validated against the EORTC QLQ-C30 and Functional Assessment of Chronic Illness Therapy- Spiritual 12 (FACIT-Sp12) in patients in palliative care facilities with cancer in Japan. Sakurai 2019 Go to paper on PubMed
• The Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-15) was validated against the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) or International Index of Erection Function (IIEF-15) in adults with MS and spinal cord injury in the Netherlands. Noordhoff 2018 Go to paper on PubMed
• The Quickscan questionnaire was validated as an assessment of return-to-work needs in long-term sickness absence in Belgium. Goorts 2019 Go to paper on PubMed
• The French Pelvic Girdle Questionnaire (PGQ) was validated against the pain intensity Numeric Rating Scale and Oswestry Disability Index in pregnant women with pelvic girdle pain in Canada. Girard 2018 Go to paper on PubMed
• The French BODY-Q was validated as a measure of body image after bariatric surgery or weight loss body contouring surgery.  Rillon 2019 Go to paper on PubMed
• A systematic review found only two PRO instruments used to assess functional recovery after Caesarian section: the Obstetric Quality of Recovery-11 achieved higher COSMIN standards than the Recovery from Caesarean Section Scale. Sharawi 2019 Go to paper on PubMed
• The Manchester-Oxford Foot Questionnaire (MOXFQ) and the Self-Reported Foot and Ankle Outcome Score (SEFAS) were validated against the SF-36 in patients undergoing foot or ankle surgery in Germany. Arbab 2018 Go to paper on PubMed
• The Musculoskeletal Health Questionnaire (MSK-HQ) was validated against the EQ-5D, RAID, PsA Impact of Disease and ASQoL in patients with inflammatory arthritis in the UK. Norton 2019 Go to paper on PubMed
• The Health Status Classification System-Preschool (HSCS-PS) was validated in a community sample of 3-year-old children in the Netherlands. Fang 2018 Go to paper on PubMed
• The Distress Thermometer was validated against the EORTC QLQ-C30 in patients undergoing resection of colorectal cancer in Sweden. Sarenmalm 2018 Go to paper on PubMed

Other PRO studies

• Quality of life on the PedsQL improved for children in the USA after treatment for obstructive sleep apnoea, but parents did not report a benefit and there was no change in Family Impact Questionnaire and Epworth Sleepiness Scale scores. Bergeron 2018 Go to paper on PubMed
• Menopause Quality of Life (MenQoL) scores were not significantly different in premenopausal women at risk of breast cancer taking low-dose tamoxifen versus fenretinide as preventive therapy in Italy. Serrano 2018 Go to paper on PubMed
• A systematic review identified 4 generic and 6 disease-specific PRO instruments that have been used in adults undergoing tonsillectomy for indications including obstructive sleep apnoea. Seethaler 2019 Go to paper on PubMed
• Discordance between patient and physician global assessment in the USA was 34% in osteoarthritis compared with 18% in rheumatoid arthritis; patient perception of pain was the main explanatory variable. Castrejon 2018 Go to paper on PubMed
• Patients with ankylosing spondylitis in Sweden have worse SF-36 quality of life than controls; living alone, long symptom duration, fatigue, and higher BASFI and ASDAS scores are associated with worse quality of life. Law 2018 Go to paper on PubMed
• Mean National Eye Institute Visual Field Questionnaire score in survivors of retinoblastoma in the USA was 81.1, scores were not affected by prior radiotherapy. Friedman 2018 Go to paper on PubMed
• A systematic review found that the EQ-5D-5L, EQ-VAS and WHO Disability Assessment Schedule version 2.0 have been validated as measures of patient-reported outcomes in perioperative trials. Moonesinghe 2019 Go to paper on PubMed

Studies reporting costs and resource use

• Prescribing of NSAIDs for pain relief increased by 22.8% in Lithuania over an 11-year period to 2016; use of EMA-restricted NSAIDs such as diclofenac, COX-2 inhibitors, nimesulide and piroxicam was high and use of safer alternatives such as paracetamol and naproxen remained low.  Kasciuskeviciute 2018 Go to paper on PubMed
• A biological approach to managing dental caries with steel crowns placed with the Hall technique reduced costs with similar clinical and quality of life outcomes compared with conventional caries management in the UK. BaniHani 2018 Go to paper on PubMed
• Total treatment costs for sunitinib in metastatic renal cell carcinoma in Finland was €30,530 per patient, with median overall survival of 17.9 months. Vuorinen 2019 Go to paper on PubMed
• Catastrophic health expenditure after reimbursement and impoverishment was higher for Hui than Han patients with type 2 diabetes in China. Sun 2019 Go to paper on PubMed
• Patients in Canada with COPD who had received influenza vaccination had a 38% reduction in influenza-related hospitalisations compared with non-vaccinated. Mulpuru 2019 Go to paper on PubMed
• US prison inmates who were HCV-positive had longer length of stay, higher 30-day readmission rates and higher costs of hospitalisations than those who were HCV-negative. Wurcel 2018 Go to paper on PubMed
• In 44 low and  middle-income countries, 17.5% of people aged 15 years and older had hypertension; of these, only 30% received treatment and 10% achieved control of their hypertension. Geldsetzer 2019 Go to paper on PubMed
• A systematic review found that the mean prevalence of hospital admissions due to non-adherence with medication was 4.29%; cardiovascular medicine nonadherence was the most prevalent, causes mainly cost and adverse events. Mongkhon 2018 Go to paper on PubMed
• A systematic review concluded that the productivity losses due to preventable disease in Australia were up to $14.9 billion for obesity, $10.5 billion due to tobacco use, $6.8 billion for excess alcohol consumption, $15.6 billion due to physical inactivity and $561 million due to diet. Crosland 2019 Go to paper on PubMed
• A systematic review found no increase in adherence to HAART overall with mobile phone interventions for people with HIV; text messages linked to support, interactivity and behaviour change techniques may be effective. Shah 2019 Go to paper on PubMed
• Mean length of hospital stay of very preterm infants in 9 European countries was 63 days in 2003 and in 2011-12, ranging from 54 days in the UK to 67 days in France. Maier 2018 Go to paper on PubMed
• Adherence to statins was >80% in survivors of myocardial infarction in Canada over 10 years, 12% of patients did not use any lipid-lowering medication. Huynh 2018 Go to paper on PubMed
• A systematic review found that the annual societal costs of Lyme disease ranged from US$0.14 per capita in the UK to $2.41 per capita in the USA; vaccination would be cost-effective in endemic regions with >1% risk of infection. Mac 2019 Go to paper on PubMed
• Mean costs of hospitalisation in adults with non-cystic fibrosis bronchiectasis in Spain was €5285; the main drivers were Pseudomonas infection, length of stay and home hospitalisation. de la Rosa Carrillo 2018 Go to paper on PubMed

Economic evaluations

• Bezlotoxumab is cost-effective at preventing recurrence of Clostridium difficile infection in older adults and those at higher risk in Spain, with an ICER of €4378 to €17,495/QALY gained compared with usual care. Salavert 2018 Go to paper on PubMed
• Oral contraceptives dominated no hormonal treatment in women with pain due to endometriosis in the UK, with more QALYs at lower cost. Grand 2019 Go to paper on PubMed
• Delaying IVF by 6 months in 8781 couples with unexplained infertility and good prognosis in Australia saved up to $15.1 million with minimal impact on pregnancy and live birth rates. Pham 2018 Go to paper on PubMed
• Adding docetaxel to hormonal therapy is cost-effective in men with metastatic prostate cancer in the UK, with an ICER of £5514/QALY compared with usual care, and dominates usual care in non-metastatic prostate cancer. Woods 2018 Go to paper on PubMed
• Epinephrine autoinjectors are only cost-effective in children with peanut allergy at a cost of $24 per injector; at current prices in the USA, the ICER is $2.7 million per QALY gained. Shaker 2018 Go to paper on PubMed
• Humanitarian paediatric cardiac surgery programs are cost-effective in low- to middle-income countries, with an ICER of $171/DALY averted. Cardarelli 2018 Go to paper on PubMed
• A systematic review concluded that CAR-T cell therapy with tisagenlecleucel and axicabtagene is generally cost-effective for large B cell lymphoma and acute lymphoblastic leukemia but their budget impact is important. Patrou 2019 Go to paper on PubMed
• Netupitant plus palonosetron is cost-effective compared with palonosetron when added to dexamethasone for chemotherapy-induced nausea and vomiting in Italy, with an ICER of €1016 and €1024 per complete response in patients with highly and moderately emetogenic risk. Giuliani 2019 Go to paper on PubMed
• Adding umeclidinium to various ICS/LABA therapy regimens was cost-effective in COPD in the UK, with an ICER of £4050 to £7210/QALY gained and £3380 to £6020/life-year gained. Driessen 2018 Go to paper on PubMed
• In people with inadequately controlled depression in the USA, augmenting antidepressants with aripiprazole or bupropion is cost-effective compared with switching to bupropion per remission gained; there were no differences in QALYs or mental health costs across groups. Yoon 2018 Go to paper on PubMed
• Adding Talimogene Laherparepvec to ipilimumab is not cost-effective compared with ipilimumab monotherapy in advanced unresectable melanoma in the USA, with an ICER of around $1.6million/progression-free QALY or life-year gained. Almutairi 2019 Go to paper on PubMed
• Laparoscopic ileocaecal resection is cost-effective compared with infliximab for people with Crohn's disease who have failed conventional therapy, with a 98% probability of cost-effectiveness at a €20,000/QALY threshold in the UK and Netherlands. de Groof 2019 Go to paper on PubMed
• Breast cancer screening of women aged 40 to 64 years within the National Breast and Cervical Cancer Early Detection Program in the USA is cost-effective, with an ICER of $51,754 versus no screening program and $50,223 vs no screening. Rim 2019 Go to paper on PubMed
• One or 5 rounds of comprehensive screening for hepatitis C is cost-effective in Belgium with an ICER less than €10,000/QALY compared with selective screening in emergency department attendees, men who have sex with men and people who inject drugs. Opstaele 2019 Go to paper on PubMed
• Nivolumab plus ipilimumab may be cost-effective in renal cell carcinoma compared with sunitinib in the US (ICER $85,506/QALY) or China (ICER $4682/QALY) but not in the UK (ICER $126,499/QALY). Wu 2018 Go to paper on PubMed

Studies reporting mortality rates or trends

• Mortality in people with bleeding oesophageal varices secondary to liver cirrhosis in Nepal was 88%; mortality was significantly predicted only by higher CTP score and serum creatinine levels. Mandal 2018 Go to paper on PubMed
• In people with atrial fibrillation, surgical ablation at the time of CABG or valve procedures reduces mortality, 5-year survival 0.69 (95%CI 0.51 to 0.92) compared with no ablation in the USA. Iribarne 2019 Go to paper on PubMed
• Mortality in US women aged 65 to 84 years with frailty was 31.2% over 12.4 years; mortality was significantly lower in women with higher intake of vegetables (9% lower hazard), nuts (13% lower) and whole grains (17% lower). Zaslavsky 2018 Go to paper on PubMed
• One-year mortality in patients admitted to hospital in Scotland in 2015 was 22.4% overall with age-sex standardised mortality of 110.4 (95%CI 104.4 to 116.5); 5.8% of all people admitted died before discharge. Moore 2018 Go to paper on PubMed
• Two-year mortality in HIV-positive people treated for Cryptococcal meningitis in Uganda was 30.9%, 20 deaths/100 person-years. Kitonsa 2019 Go to paper on PubMed
• There were an estimated 22,527 deaths out of 53.2 million cases of Dengue in India in 2016 at a cost of $5.71 billion; cases increased by 29% and costs by 12% from 2013 but mortality fell by 9%. Hariharan 2019 Go to paper on PubMed