A Systematic Literature Review of Health Utility Values in Breast Cancer

Manraj N Kaur; Jiajun Yan; Anne F Klassen; Justin P David; Dilshan Pieris; Manraj Sharma; Louise Bordeleau; Feng Xie

doi:10.1177/0272989X211065471

A Systematic Literature Review of Health Utility Values in Breast Cancer

Med Decis Making. 2022 Jul;42(5):704-719. doi: 10.1177/0272989X211065471. Epub 2022 Jan 18.

Authors

Manraj N Kaur¹, Jiajun Yan², Anne F Klassen³, Justin P David⁴, Dilshan Pieris⁴, Manraj Sharma⁴, Louise Bordeleau⁵, Feng Xie²

Affiliations

¹ School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
² Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
³ Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
⁴ Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁵ Department of Oncology, Division of Medical Oncology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.

Abstract

Background: Health utility values (HUVs) are important inputs to the cost-utility analysis of breast cancer interventions.

Purpose: Provide a catalog of breast cancer-related published HUVs across different stages of breast cancer and treatment interventions.

Data sources: Systematic searches of MEDLINE, MEDLINE In-Process, EMBASE, Web of Science, CINAHL, PsycINFO, EconLit, and Cochrane databases (2005-2017).

Study selection: Studies published in English that reported mean or median HUVs using direct or indirect methods of utility elicitation for breast cancer.

Data extraction: Independent reviewers extracted data on a preestablished and piloted form; disagreements were resolved through discussion.

Data analysis: Mixed-effects meta-regression using restricted maximum likelihood modeling was conducted for intervention type, stage of breast cancer, and typical clinical and treatment trajectory of breast cancer patients to assess the effect of study characteristics (i.e., sample size, utility elicitation method, and respondent type) on HUVs.

Data synthesis: Seventy-nine studies were included in the review. Most articles (n = 52, 66%) derived HUVs using the EQ-5D. Patients with advanced-stage breast cancer (range, 0.08 to 0.82) reported lower HUVs as compared with patients with early-stage breast cancer (range, 0.58 to 0.99). The meta-regression analysis found that undergoing chemotherapy and surgery and radiation, being diagnosed with an advanced stage of breast cancer, and recurrent cancer were associated with lower HUVs. The members of the general public reported lower HUVs as compared with patients.

Limitations: There was considerable heterogeneity in the study population, health states assessed, and utility elicitation methods.

Conclusion: This review provides a catalog of published HUVs related to breast cancer. The substantial heterogeneity in the health utility studies makes it challenging for researchers to choose which HUVs to use in cost-utility analyses for breast cancer interventions.

Keywords: PRISMA; breast cancer; economic evaluation; health state utility values; health states; health status; health utilities; health-related quality of life; meta-regression; review; utility score.

Publication types

Systematic Review

MeSH terms

Breast Neoplasms* / therapy
Cost-Benefit Analysis
Female
Humans