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首页> 美国卫生研究院文献>Springer Open Choice >Valuing health-related quality of life in heart failure: a systematic review of methods to derive quality-adjusted life years (QALYs) in trial-based cost–utility analyses
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Valuing health-related quality of life in heart failure: a systematic review of methods to derive quality-adjusted life years (QALYs) in trial-based cost–utility analyses

机译：评估心力衰竭中与健康相关的生活质量：在基于试验的成本-效用分析中系统推导质量调整生命年（QALYs）的方法的系统综述

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摘要

The accurate measurement of health-related quality of life (HRQoL) and the value of improving it for patients are essential for deriving quality-adjusted life years (QALYs) to inform treatment choice and resource allocation. The objective of this review was to identify and describe the approaches used to measure and value change in HRQoL in trial-based economic evaluations of heart failure interventions which derive QALYs as an outcome. Three databases (PubMed, CINAHL, Cochrane) were systematically searched. Twenty studies reporting economic evaluations based on 18 individual trials were identified. Most studies (n = 17) utilised generic preference-based measures to describe HRQoL and derive QALYs, commonly the EQ-5D-3L. Of these, three studies (from the same trial) also used mapping from a condition-specific to a generic measure. The remaining three studies used patients’ direct valuation of their own health or physician-reported outcomes to derive QALYs. Only 7 of the 20 studies reported significant incremental QALY gains. Most interventions were reported as being likely to be cost-effective at specified willingness to pay thresholds. The substantial variation in the approach applied to derive QALYs in the measurement of and value attributed to HRQoL in heart failure requires further investigation.
机译：准确测量与健康相关的生活质量（HRQoL）并为患者改善其价值，对于推导质量调整的生命年（QALYs）以告知治疗选择和资源分配至关重要。这项审查的目的是在心力干预措施的基于试验的经济评估中确定和描述用于衡量和评估HRQoL变化的方法，这些评估可得出QALY。系统地搜索了三个数据库（PubMed，CINAHL，Cochrane）。确定了二十项研究，这些研究报告了基于18项单独试验的经济评估。大多数研究（n = 17）使用通用的基于偏好的度量来描述HRQoL并得出QALY，通常是EQ-5D-3L。其中，三项研究（来自同一试验）也使用了从特定条件到通用度量的映射。其余三项研究使用患者对自身健康状况的直接评估或医生报告的结果得出QALY。 20项研究中只有7项报告了QALY显着增加。据报告，大多数干预措施在特定的支付意愿下很可能具有成本效益。心力衰竭中HRQoL的测量值和归因于QALYs的方法的重大变化需要进一步研究。

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