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A systematic review and meta-analysis of childhood health utilities
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Kwon, J., Kim, Sung Wook, Ungar, W. J., Tsiplova , K., Madan, Jason and Petrou, Stavros (2018) A systematic review and meta-analysis of childhood health utilities. Medical Decision Making, 38 (3). pp. 277-305. doi:10.1177/0272989X17732990
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WRAP-systematic-review-meta-analysis-childhood-utilities-Petrou-2017.pdf - Accepted Version - Requires a PDF viewer. Download (1139Kb) | Preview |
Official URL: https://doi.org/10.1177/0272989X17732990
Abstract
Background:
A common feature of most reviews or catalogues of health utilities has been their focus on adult health states or derivation of values from adult populations. More generally, utility measurement in or on behalf of children has been constrained by a number of methodological concerns. The objective of this study was to conduct the first comprehensive systematic review and meta-analysis of primary utility data for childhood conditions and descriptors and to determine the effects of methodological factors on childhood utilities.
Methods:
The review followed PRISMA guidelines. PubMed, Embase, Web of Science, PsycINFO, EconLit, CINAHL and Cochrane Library were searched for primary studies reporting health utilities for childhood conditions or descriptors using direct or indirect valuation methods. The Pediatric Economic Database Evaluation (PEDE) was also searched for cost-utility analyses with primary utility values. Mean or median utilities for each of the main samples were catalogued, whilst weighted averages of utilities for each health condition were estimated, by valuation method. Mixed-effects meta-regression using hierarchical linear modelling was conducted for the most common valuation methods to estimate the utility decrement for each health condition category relative to general childhood population health, as well as the independent effects of methodological factors.
Results:
The literature searches resulted in 272 eligible studies. These yielded 3,414 utilities when all sub-groups were considered, covering all ICD-10 chapters relevant to childhood health, 19 valuation methods, 12 respondent types, 8 modes of administration, and data from 36 countries. A total of 1,191 utility values were obtained when only main study samples were considered and these were catalogued by health condition or descriptor, and methodological characteristics. 1,073 mean utilities for main samples were used for fixed-effects meta-analysis by health condition and valuation method. Mixed-effects meta-regressions estimated that 53 of 76 ICD-10 delineated health conditions valued using the HUI3 were associated with statistically significant utility decrements relative to general population health, whilst 38 of 57 valued using a Visual Analogue Scale (VAS) were associated with statistically significant VAS decrements. For both methods, parental proxy-assessment was associated with overestimation of values, whilst adolescents reported lower values than children under 12 years. VAS responses were more heavily influenced by mode of administration than the HUI3.
| Item Type: | Journal Article | |||||||||
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| Subjects: | R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services | |||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Children -- Health and hygiene -- Statistics, Health status indicators -- Databases | |||||||||
| Journal or Publication Title: | Medical Decision Making | |||||||||
| Publisher: | Sage Publications, Inc. | |||||||||
| ISSN: | 0272-989X | |||||||||
| Official Date: | April 2018 | |||||||||
| Dates: |
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| Volume: | 38 | |||||||||
| Number: | 3 | |||||||||
| Page Range: | pp. 277-305 | |||||||||
| DOI: | 10.1177/0272989X17732990 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Access rights to Published version: | Restricted or Subscription Access | |||||||||
| RIOXX Funder/Project Grant: |
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