Published: 01-09-2020

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 September 2020.

Studies reporting utilities

•  A review of the English EQ-5D-5L value set and time trade-off experiments found weaknesses in the data with inconsistent and incomplete responses. Hernandez Alava 2020 Go to paper on PubMed
• EQ-5D and EORTC QLQ-C30 scores improved over 24 weeks in patients with relapsed/refractory Hodgkin's lymphoma receiving pembrolizumab. von Tresckow 2019 Go to paper on PubMed
• EQ-5D values, absenteeism and presenteeism were significantly worse in patients who responded to triptans in 3 or fewer out of every 5 migraine attacks than in patients who responded in 4 or more out of every 5 attacks. Lombard 2020 Go to paper on PubMed
• A systematic review found that the HUI3 was the most commonly-used tool for proxy measures of childhood utilities; parents usually underestimate and healthcare professionals overestimate utilities compared with child self-reports. Khadka 2019 Go to paper on PubMed
• The EQ-5D-3L was validated against the Quality of Life in Alzheimer's Diseases (QoL-AD) in patients with dementia in Germany. Michalowsky 2020 Go to paper on PubMed
• EQ-5D-5L population norms were developed for the general population in Iran; mean score was 0.79 and mean EQ-VAS score was 71.72. Emrani 2020 Go to paper on PubMed
• A systematic review found that the SF-36, SF-12 and EQ-5D were the instruments most commonly used to assess quality of life in general injury populations. Geraerds 2020 Go to paper on PubMed
• The Oxford Hip Score (OHS) and Oxford Knee Score (OKS) questionnaires were  mapped to EQ-5D-5L utility scores in patients with lower limb osteoarthritis in Spain. Martin-Fernandez 2020 Go to paper on PubMed
• The EQ-5D-5L, AQoL-8D, ICECAP-O, ASCOT, DEMQOL-U and AD-5D preference measures were compared for content and face validity in patients with dementia and their caregivers in Australia. Engel 2020 Go to paper on PubMed
• EQ-5D and SF-12 scores were lower in patients with typical or atypical angina than in patients with other chest pain referred for diagnostic coronary angiography in Europe. Rieckmann 2020 Go to paper on PubMed
• UK utility weights were determined for the EORTC QLU-C10D multi-attribute utility tool for patients with cancer based on a discrete choice experiment. Norman 2019 Go to paper on PubMed
• A systematic review found that disutilities associated with microcephaly after Zika virus infection were -0.745 to -0.820; time traded off expected lifetime for Guillain-Barre syndrome after Zika was 16 days to 3 years. Miranda 2020 Go to paper on PubMed
• A systematic review identified EQ-5D-derived health state utility values for haematological malignancies: multiple myeloma, CLL, CML, AML, Non-Hodgkin's lymphoma and mantle cell lymphoma were the best represented. Golicki 2020 Go to paper on PubMed
• Mean EQ-5D-3L index scores improved from 0.48 1 week after trauma requiring hospitalisation to 0.74 after 3 months and EQ-VAS scores improved from 56 to 73; recall bias made a significant difference but correlated with prospective scores. Haagsma 2020 Go to paper on PubMed

Studies validating a PRO instrument

• A systematic review concluded that the Burn Specific Health Scale-Brief and the Brisbane Burn Scar Impact Profile had the best measurement properties to assess quality of life after burns. Legemate 2020 Go to paper on PubMed
• The revised Trauma Quality-of-Life (T-QoL) was validated against the SF-12 and Breslau post-traumatic stress disorder screening tool (B-PTSD) in adult trauma survivors in the USA. Herrera-Escobar 2020 Go to paper on PubMed
• A systematic review found that the Self-Reported Charlson Comorbidity Index and the Self-Administered Comorbidity Questionnaire were most commonly used PRO tools to assess morbidity, but reliability varied by disease. Oemrawsingh 2020 Go to paper on PubMed
• The minimum important difference in Nasal Symptom Score (T4NSS) was -0.90 in children, -0.74 in adolescents and -1.04 in adults with house dust mite allergy in France and Germany. Devillier 2019 Go to paper on PubMed
• The Dystonia Non-Motor Symptoms Questionnaire (DNMSQuest) was validated against the EQ-5D and the CDQ-24 in patients with craniocervical dystonia in Germany and the UK. Klingelhoefer 2019 Go to paper on PubMed
• The Minnesota living with heart failure questionnaire (MLHFQ) was mapped to EQ-5D-5L in patients with heart failure in Australia. Kularatna 2020 Go to paper on PubMed
• The GC-PROM was validated as a measure of quality of life in patients with stomach cancer in China. Hu 2020 Go to paper on PubMed
• The Multidimensional Task Ability Profile (MTAP) was validated against the Oswestry Disability Index (ODI), Neck Disability Index (NDI), Disabilities of the Arm, Shoulder, and Hand (DASH), Lower Extremity Functional Scale (LEFS), and Short Form 12 Health-Related Quality of Life (SF-12) questionnaires in patients undergoing musculoskeletal rehabilitation in the USA. Verna 2019 Go to paper on PubMed
• The Versailles Metacognitive Strategies Evaluation Questionnaire was validated against other PRO tools as an assessment of metacognitive and help-seeking strategies in patients with schizophrenia in France. Brunet-Gouet 2020 Go to paper on PubMed
• The COPD Assessment Test (CAT) correlated well with the Cystic Fibrosis Questionnaire Revised (CFQ-R) and the St George's Respiratory Questionnaire (SGRQ) in patients with cystic fibrosis in Germany. Pott 2020 Go to paper on PubMed
• The telephone-based ABILHAND questionnaire was validated in people after a stroke in Brazil. Avelino 2020 Go to paper on PubMed
• A single brief question based on the International Physical Activity Questionnaire was validated as a measure of physical activity in adults in Spain. Moreno-Llamas 2020 Go to paper on PubMed
• The SCAR-Q was validated against the Patient and Observer Scar Assessment Scale (POSAS) in children and adults with scars due to surgery, trauma or burns in Canada, Chile, New Zealand and the USA. Ziolkowski 2020 Go to paper on PubMed

Other PRO studies

• A systematic review concluded that regularly-supported self-management interventions improve quality of life in patients with asthma compared with usual care. Hodkinson 2020 Go to paper on PubMed
• A systematic review found that 5 PRO instruments have been validated as assessments of quality of life in bladder cancer: BCI, EORTC QLQ-NMIBC24, FACT-VCI, BUSS and FACT-BL. Mina 2019 Go to paper on PubMed
• Quality of life (PFIQ-7 questionnaire) and pelvic floor symptoms (PFDI-20 questionnaire) were significantly worse in survivors of gynaecological cancer than in control women in France. Neron 2019 Go to paper on PubMed
• A systematic review found that 43.8% of nurses in China had depression in studies published in 1996 to 2019, of whom 31% had mild symptoms. Xie 2020 Go to paper on PubMed

Studies reporting costs and resource use

• Acute care surgery rates fell from 2.3 patients per day in 2019 to 0.9 per day during COVID-19 in one hospital in Spain: acute cholecystitis and post-operative complications decreased but bowel obstruction and abdominal wall hernias increased, mortality and reoperation rates were similar in both groups. Cano-Valderrama 2020 Go to paper on PubMed
• Use of ticagrelor increased in patients after STEMI in the US from 18% in 2013 to 44% in 2017; use of prasugrel and clopidogrel fell over the same period. Faridi 2020 Go to paper on PubMed
• Total spending on tuberculosis by 135 low and middle-income countries increased by 3.9% per year between 2000 and 2017 but out-of-pocket spending decreased by 0.8% per year; 30 high-prevalence countries accounted for 73.7% of all TB spending in 2017. Su 2020 Go to paper on PubMed
• A model predicted that if social distancing and quarantine can reduce the reproductive number of COVID-19 to 1.25, active monitoring of 50% of contacts can result in overall outbreak control (R<1). Peak 2020 Go to paper on PubMed
• Deep vein thrombosis occurred in 0.623% of patients receiving emergency general surgery in the USA in 2001-2015, with additional hospital-related costs of $22,301 per patient than those without DVT. Gantz 2020 Go to paper on PubMed
• A systematic review concluded that palliative care in patients with cancer reduced the cost of health care by $1285-$20,719 for inpatient palliative care, $1000-$5198 for outpatient and inpatient combined, $4258 for home-based, and $117-$400 per day for home/hospice, combined outpatient/inpatient palliative care. Yadav 2020 Go to paper on PubMed
• Use of paediatric emergency healthcare was 63.8% lower in Germany in the 4 weeks after lockdown for COVID-19 than in the corresponding month in 2019 but a higher proportion of attendees required hospitalisation. Dopfer 2020 Go to paper on PubMed
• A systematic review found the mean cost of diarrhoeal illness in low- and middle-income countries was $36.56 (median $15.73) per outpatient episode and $159.90 (median $85.85) per inpatient episode. Baral 2020 Go to paper on PubMed

Economic evaluations

•  A systematic review concluded that spinal cord stimulation was likely to be cost-effective for failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS) over a long-term time horizon. Niyomsri 2020 Go to paper on PubMed
• A systematic review calculated that social returns on investment of physical activity and sport interventions to prevent non-communicable disease ranged from 3:1 to 124:1. Gosselin 2020 Go to paper on PubMed
• A systematic review found that the cost-benefit ratio of promoting hygiene measures in medical and surgical units was 2.48 to 7.66 to prevent drug-resistant C difficile, MRSA, vancomycin-resistant enterococci and carbapenem-resistant Gram-negative bacterial infections. Tchouaket Nguemeleu 2020 Go to paper on PubMed
• Hydrocortisone did not significantly reduce mortality or hospital costs and did not improve QALYs compared with placebo in patients with septic shock in Australia, with an ICER of A$1,254,078/QALY gained. Thompson 2020 Go to paper on PubMed
• Mass drug administration plus intensified malaria vector control is cost-effective in Mozambique with an ICER of $987/DALY averted compared with usual control measures. Cirera 2020 Go to paper on PubMed
• A systematic review concluded that existing economic models of antipsychotics in schizophrenia were generally low quality due to not including adverse event data and not using the best input data. Jin 2020 Go to paper on PubMed
• The net monetary benefit of bariatric surgery compared with diet and exercise in people with obesity in Italy was €54,647 to €122,960, or up to €380,286 from a societal perspective, and turns positive after 2 to 4 years. Rognoni 2020 Go to paper on PubMed
• Dabigatran is cost-effective compared with rivaroxaban to prevent stroke and systemic embolism in people with atrial fibrillation in China, with an ICER of ¥112,910/QALY gained. Dong 2020 Go to paper on PubMed
• Pembrolizumab is cost-effective compared with chemotherapy in patients with metastatic non-small-cell carcinoma of the lung in the USA, with an ICER of $47,596 to $68,061/QALY. Weng 2020 Go to paper on PubMed
• The cost-effectiveness ratio per month was JPY 391,551.3/PFS for palbociclib and JPY 488,690.5/PFS for everolimus in advanced and recurrent breast cancer in Japan. Kimura 2019 Go to paper on PubMed

Studies reporting mortality rates and trends

• In-hospital mortality from COVID-19 was 24.8% in one US hospital in March-April 2020 with 30.8% requiring ICU care and mean length of stay of 11.82 days. Turcotte 2020 Go to paper on PubMed
• Deaths from heart disease in the USA fell from 1999 to 2011, then increased to 2018; over time, fewer deaths were due to ischaemic heart disease and more to heart failure and hypertensive heart disease. Shah 2020 Go to paper on PubMed
• Of 78 children admitted in the UK with paediatric inflammatory multisystem syndrome due to COVID-19, 2 died, 36 were ventilated, 3 received ECMO; 67% were male and 78% from ethnic minorities. Davies 2020 Go to paper on PubMed
• The 7-day mortality was 13% in 20,000 hospitalised patients with COVID-19 in the USA who received convalescent plasma. Joyner 2020 Go to paper on PubMed
• 62% of 26 patients admitted to ICU for COVID-19 in France had pulmonary embolism but only 3 had lower limb DVT; ICU mortality was 69% compared with 20% in those without pulmonary embolism. Contou 2020 Go to paper on PubMed
• 5-year survival in women with stage3 or 4 ovarian cancer in New Zealand was 21.7% in 2000-2002 and 23.2% in 2010-2012 (p=0.80). Yeoh 2019 Go to paper on PubMed
• Increased AST levels were more strongly associated with mortality than other measures of liver function in 5,771 adults with COVID-19 in Hubei Province, China. Lei 2020 Go to paper on PubMed
• Cancer-specific and overall survival was significantly higher after 15 years in Japanese men who had received PSA-based population screening for prostate cancer than those not screened. Tabei 2020 Go to paper on PubMed
• Mortality in patients critically ill with COVID-19 in the USA who received convalescent plasma was 0.3% in the first 4 hours and 14.9% after 7 days. Joyner 2020 Go to paper on PubMed
• Mortality in patients with CLL who contracted COVID-19 was 33% in an international study, treatment with Bruton tyrosine kinase inhibitors (BTKi) did not affect mortality. Mato 2020 Go to paper on PubMed
• The 4C mortality score was able to predict mortality in UK patients admitted to hospital with COVID-19: patients with a score of 15 or more out of 21 had a 62% mortality, a score of 3 or less had  1% mortality. Knight 2020 Go to paper on PubMed
• Strict confinement only of adults aged 60 and older in Brazil against COVID-19 from 1st May was predicted to lead to 400,000 hospitalisations, 50,000 ICU cases and 120,000 deaths in adults aged 50 to 60 years; also confining 50 to 60 year-olds would prevent health system collapse. Lyra 2020 Go to paper on PubMed
• In-hospital mortality was 22% in 10,021 patients hospitalised for COVID-19 in Germany; 24% were aged below 60, 12% of women and 22% of men were ventilated for a mean 13.5 days. Karagiannidis 2020 Go to paper on PubMed
• Of 2217 patients admitted with COVID-19 in the UK, South Asian ethnicity was associated with a significantly higher risk of death by Cox regression after adjusting for age, sex, deprivation and comorbidities and propensity score matching, with a HR of 1.3 to 1.4. Sapey 2020 Go to paper on PubMed
• Mortality in patients  with COVID-19 in France was 37% for those admitted to ICU within 7 days, 21% in those admitted to ICU 8 to 14 days and 12% in those admitted to ICU >14 days after disease onset. Azoulay 2020 Go to paper on PubMed
• The Palliative Performance Scale measure of frailty was validated as a predictor of mortality in adults admitted with COVID-19 in the USA. Fiorentino 2020 Go to paper on PubMed