Published: 01-05-2020

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 May 2020.

Studies reporting utilities

• Improvement in EQ-5D values after total hip arthroplasty in Sweden was associated with higher patient satisfaction, improved activities of daily living and reduced pain, anxiety and depression. Ray 2020 Go to paper on PubMed
• EQ-5D-3L utilities derived from the PDQ-39 improved significantly after deep brain stimulation in patients with Parkinson's disease. Zahra 2020 Go to paper on PubMed
• SF-36 scores, anxiety and respiratory function were significantly better after 6 weeks of respiratory rehabilitation compared with no rehabilitation in elderly patients after COVID-19 in China. Liu 2020 Go to paper on PubMed
• EQ-5D-5L scores were lowest in parents of children with asthma than other atopic disorders in Korea, mean EQ-5D index score was 0.936 and EQ-VAS 79.3. Hwang 2019 Go to paper on PubMed
• Caregivers of children with cystic fibrosis in Germany, Ireland, the UK and US reported worsening of SF-12, Child Health Questionnaire-Parent Form 28 and Work Productivity and Activity Impairment subscale scores during a pulmonary exacerbation. Suthoff 2019 Go to paper on PubMed
• Based on changes in EQ-5D utility values, mammography screening for breast cancer leads to a net QALY loss in Norway, with QALY losses due to overdiagnosis greater than QALY gains from improved survival. Zahl 2020 Go to paper on PubMed

Studies validating a PRO instrument

• The Arabic SF-36 was validated against Activities of Daily Living scale scores in elderly adults in Lebanon. El Osta 2019 Go to paper on PubMed
• The Munich Dysphagia Test-Parkinson's Disease (MDT-PD) and the NMS-3 swallowing question from the nonmotor symptom questionnaire for Parkinson's disease (NMSQuest) were not accurate enough to be a screening test for aspiration in Parkinson's disease. Buhmann 2019 Go to paper on PubMed 
• The COPD Assessment Test was validated in patients with connective tissue disease-associated interstitial lung disease in Japan. Suzuki 2019 Go to paper on PubMed
• The Oswestry Disability Index and the Scoliosis Research Society-30 Questionnaire (SRS-30) were validated against the SF-36 and pain VAS scores in adults with degenerative spinal disease in Finland. Repo 2019 Go to paper on PubMed
• A systematic review identified 3 instruments that are potentially valid for screening of psychosocial problems in Duchenne and Becker muscular dystrophy: the Psychosocial Adjustment and Role Skills Scale, Pediatric Quality of Life Inventory Generic module, and Life Satisfaction Index for Adolescents with Duchenne muscular dystrophy. Hellebrekers 2019 Go to paper on PubMed
• The Northwick Park and Bournemouth neck pain questionnaires and the Neck Disability Index (NDI) were more responsive and reliable than the Copenhagen neck disability scale in assessing response to physical therapies after whiplash injury in the UK. Stefanovitch-Lawbuary 2019 Go to paper on PubMed
• A systematic review found limited evidence to support the psychometric robustness of the Prolapse Quality of Life (P-QoL) questionnaire and cross-cultural adaptations for non-English-speaking populations. Belayneh 2019 Go to paper on PubMed
• The Telephone Interview for Cognitive Status (TICS) was validated against the Mini-Mental State Examination (MMSE), and Addenbrooke's Cognitive Examination-Revised (ACE-R) as a screening tool for dementia in older adults in Australia. Bentvelzen 2019 Go to paper on PubMed
• Only 50% of adults with lower urinary tract symptoms in the USA accurately and fully completed a 3-day voiding and fluid intake diary; correlation between diary data and questionnaire responses was moderate. Cameron 2019 Go to paper on PubMed 
• Mean scores of the Parent Report of Children's Abilities-Revised (PARCA-R) were close to 100 for children under 2 years in the UK; 93 for children born very pre-term and 89 for those who had neonatal sepsis. Johnson 2019 Go to paper on PubMed

Other PRO studies

• Water exercises improved FACT-B emotional well-being scores and yoga improved social/family well-being scores more than pilates after 12 months in patients with breast cancer in Ukraine. Odynets 2019 Go to paper on PubMed
• Patients in Indonesia had higher pain and worse Knee Society Score (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores than patients in the USA before total knee arthroplasty, but similar post-operative scores. Budhiparama 2019 Go to paper on PubMed
• Women with fibromyalgia in Brazil had worse King's Health Questionnaire (KHQ) scores and were more likely to have pelvic floor dysfunction than those without fibromyalgia. Fusco 2019 Go to paper on PubMed
• Adjusted Quality of Life Index-Dialysis version (QLI-D) scores were 2.81 points higher in patients receiving peritoneal dialysis than haemodialysis in  medical centres and 2.53 points lower in those receiving peritoneal dialysis in clinics in Taiwan. Hsu 2020 Go to paper on PubMed
• Auricular acupressure reduced nausea, vomiting and breast symptoms more than controls in patients receiving chemotherapy for breast cancer in Brazil; EORTC QLQ-C30 and QLQ-BR23 scores improved in both groups. Vallim 2019 Go to paper on PubMed
• Dyspareunia and acyclic pelvic pain predicted worse quality of life on the Endometriosis Health Profile (EHP-30) Questionnaire in women with ovarian endometriosis in Brazil. Florentino 2019 Go to paper on PubMed
• A systematic review found that cognitive behavioural therapy (CBT) can improve depression and quality of life in patients receiving haemodialysis with depression. Ng 2019 Go to paper on PubMed
• Symptoms of irritable bowel syndrome were present in 32% of patients with inactive ulcerative colitis, 35% with inactive Crohn's disease and 14% of controls in Turkey, significantly lowering inflammatory bowel disease questionnaire quality of life scores. Ozer 2020 Go to paper on PubMed
• Minnesota Living With Heart Failure Questionnaire scores were lower in people with heart failure due to Chagas disease than other aetiologies in Mexico. Paz 2019 Go to paper on PubMed

Studies reporting costs and resource use

• Mean length of stay for 614 patients with juvenile nasopharyngeal angiofibroma decreased by 0.14 days in the US from 1997 to 2016 but cost per day increased by $2380 per year. Yu 2020 Go to paper on PubMed
• 14.3% of hospital admissions of adults aged >65 years in New York City in 2000-2014 required ICU admission; in 2012-14, 20.7% of patients admitted to ICU had infections, 33.4% had CVD and 14.5% died in hospital. Illescas 2020 Go to paper on PubMed
• In patients initially compliant with preventive therapy after osteoporotic fractures in Canada, persistence was 66.4% at 1 year and 55.6% at 2 years; >80% of days were covered in 64.2% of patients for 1 year and 62.5% for 2 years. Senay 2019 Go to paper on PubMed
• Total annual cost of managing invasive cervical cancer in Brazil in 2016 was US$2,219.73 per patient; 81.2% were direct costs. Santos 2019 Go to paper on PubMed
• A systematic review found that mean 1-year costs of cardiovascular events ranged from $4456 for heart failure in China to $61,864 for MI in the US; CVD procedural costs ranged from $17,923 for PCI in Italy to $76,279 for CABG in the US. Ryder 2019 Go to paper on PubMed
• A systematic review found that preterm infants hospitalised for respiratory syncytial virus infections have greater healthcare resource use and worse outcomes than full-term infants. Kenmoe 2020 Go to paper on PubMed
• People in the USA with peanut allergy incurred almost double all-cause healthcare costs compared with controls in 2010-2016, with 36% having an anaphylactic reaction during follow-up. Shaker 2020 Go to paper on PubMed
• A systematic review found costs of interventions to control schistosomiasis ranged from US$0.06 to US$4.46 per person treated, with highly heterogeneous reporting. Salari 2020 Go to paper on PubMed
• Annual costs of inpatient care for patients with depression in 2014 was €9397 per patient in Germany and €2963 in Poland. Zaprutko 2019 Go to paper on PubMed
• Telemedicine virtual house calls reduced time and costs compared with usual care in patients with multiple sclerosis in the US and satisfaction was high. Robb 2019 Go to paper on PubMed
• Median costs of rectal resection in Australia were $15,882 with no postoperative complications and $22,567 with complications. Johnston 2020 Go to paper on PubMed
• A systematic review found that major depression was associated with higher direct costs in adolescents, adults and the elderly compared with no depression, and higher indirect costs in adults. Konig 2019 Go to paper on PubMed
• Mean lifetime antibiotic cost was $8171 in patients allergic to penicillin in the USA compared to $6278 for those not allergic, with greater use of fluoroquinolones and moderate-spectrum antibiotics. Au 2019 Go to paper on PubMed
• The annual direct medical costs of cystic fibrosis were €17,551 per patient in Germany in 2016, mainly due to outpatient drug prescriptions. Frey 2019 Go to paper on PubMed

Economic evaluations

• A once-daily single fluticasone furoate (FF)/umeclidinium (UMEC)/vilanterol (VI) inhaler was cost-effective in people with COPD in Canada, with an ICER of C$18,989/QALY compared with FF/VI alone and C$13,776 versus UMEC/VI. Ismaila 2019 Go to paper on PubMed
• Both ROTARIX and ROTAVAC rotavirus vaccinations are cost-effective in Palestine compared with no vaccine; ROTAVAC has lower costs. Debellut 2020 Go to paper on PubMed
• Despite nusinersen not being shown to be cost-effective compared with usual care for spinal muscular atrophy in Sweden at a willingness-to-pay threshold of €195,600, it gained reimbursement for patients under 18 years of age. Zuluaga-Sanchez 2019 Go to paper on PubMed
• Biosimilar rituximab and generic mycophenolate mofetil were cost-effective in people with neuromyelitis optica spectrum disorder in Thailand who were resistant to azathioprine. Aungsumart 2020 Go to paper on PubMed
• Continuous positive airway pressure (CPAP) is cost-effective for obstructive sleep apnea (OSA) in Australia, with an ICER of $12,495 per DALY averted from a healthcare perspective and cost-saving from a societal perspective (-$10 688 per DALY averted). Streatfeild 2019 Go to paper on PubMed
• A systematic review found that coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) were cost-effective compared to medical therapy in patients with coronary artery disease. Gholami 2019 Go to paper on PubMed
• Atezolizumab plus chemotherapy was not cost-effective as first-line therapy for extensive small-cell lung cancer in China, with an ICER of $489,013/QALY compared with chemotherapy alone. Li 2019 Go to paper on PubMed
• Telemonitoring of Crohn's Disease and Ulcerative Colitis is cost-effective, with lower costs per additional patient in remission or QALY gained than usual care in Spain. DelHoyo 2019 Go to paper on PubMed
• Adding atezolizumab to bevacizumab, carboplatin and paclitaxel (BCP) is not cost-effective for first-line therapy of non-small-cell lung cancer in the US, with an ICER of $568,114/QALY compared with BCP alone. Wan 2019 Go to paper on PubMed
• Blood genetic screening adults aged under 40 years in Portugal for colorectal cancer susceptibility genes is only cost-effective if there is a 5-fold increase in risk and testing cost is less than €30 per patient. Pereira 2019 Go to paper on PubMed
• Gemcitabine plus cisplatin is cost-effective first-line therapy for recurrent or metastatic nasopharyngeal carcinoma in China, with an ICER of $7,386/QALY compared with fluorouracil plus cisplatin. Chen 2019 Go to paper on PubMed
• A systematic review conlcuded that intravitreal ranibizumab or bevacizumab are cost-effective treatments for diabetic macular oedema but not other diabetic retinopathy compared with laser photocoagulation or anti-vascular endothelial growth factor (VEGF) therapies. Maniadakis 2019 Go to paper on PubMed
• Extending influenza vaccination to school-aged children would be cost-saving in Mexico, with 671,461 fewer cases nationally, 55% of cases averted in schoolchildren, with healthcare cost savings of US$112million/year. Falcon-Lezama 2020 Go to paper on PubMed

Studies reporting mortality rates or trends

• Mortality from alcohol-associated liver disease was 13.1/100,000 men and 5.6/100,000 women in the US in 2017, and has increased in almost every age group and race since 2006. Moon 2020 Go to paper on PubMed
• Three-month mortality was 9.3% in adults aged >70 years after an acute hospital admission in the Netherlands; higher Geriatric Depression Scale scores and feeling of hopelessness were predictive of mortality. Reichardt 2019 Go to paper on PubMed 
• Mortality in severe COVID-19 infection in China was higher in patients with diabetes than without diabetes, adjusted HR 1.53 (95%CI 1.02 to 2.30, p=0.041), median survival from admission was 10 days without diabetes versus 18 days with diabetes. Yan 2020 Go to paper on PubMed
• Mortality rate was 4.3% in children admitted to paediatric cardiac ICUs in the US in 2014 to 2017 who did not receive surgery, with expected mortality between 2.6% and 8.3%. Gaies 2019 Go to paper on PubMed
• Five-year survival was 44.5% overall in patients >40 years with osteosarcoma in Japan in 2000 to 2016; 64.3% after definitive surgery and 51.1% in those without distant metastases at diagnosis. Imura 2019 Go to paper on PubMed
• In adults in Japan, consumption of Go to paper on PubMed
• 28-day mortality was 31.6% in children admitted to PICU with severe sepsis in Argentina in 2008; shock and development of acute respiratory distress syndrome predicted mortality. Jabornisky 2019 Go to paper on PubMed
• Overall stillbirth rate in Brazil in 2003 to 2017 was 11.9%; 25.7% of mothers had no prenatal care and rates of maternal syphilis increased over time. Fonseca 2019 Go to paper on PubMed
• 5-year survival was 15.6% higher in patients in China receiving care for breast cancer by a well-organised multidisciplinary care team (MDT) than in those treated without MDT, but was 19.9% lower with disorganised MDT than no MDT. Lu 2019 Go to paper on PubMed
• An observational study of 80 patients treated with hydroxychloroquine and azithromycin for relatively mild COVID-19 infection in France found that one patient died and one remained on intensive care. Gautret 2020 Go to paper on PubMed
• Probability of disability-free survival to age 25 years was 4.1% in infants born at 22 week gestational age, 53% at 25 weeks, 78.3% at 28 weeks and 97.2% at 39 to 41 weeks in Australia in 1983 to 2010; disability-free survival was higher in Caucasian than Aboriginal infants with the same levels of risk. Bourke 2019 Go to paper on PubMed
• A comparative observational study of 173 adults with COVID-19 who required oxygen but not ICU care in France found no significant difference in 21-day mortality and weaning from oxygen with hydroxychloroquine versus no hydroxychloroquine; 10% developed ECG changes leading to discontinuation. Mahevas 2020 Go to paper on PubMed 
• Of patients with acute myocardial infarction in Norway in 2001-2014, 11.4% died within 28 days of hospitalisation and 10.1% of the survivors died within 1 year; 28-day CVD mortality decreased 5.2% per year and 1-year CVD mortality by 6.2% per year. Sulo 2019 Go to paper on PubMed