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Health-related quality of life as measured by the EQ-5D in the prevention, screening and management of cervical disease: A systematic review

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Abstract

Purpose

Cost-effectiveness analyses (CEAs) of screening can be highly sensitive to the health-related quality of life (HRQoL) effects of screen tests and subsequent treatment. Accordingly, accurate assessment of HRQoL is essential. We reviewed the literature regarding HRQoL in cervical prevention and management in order to appraise the current evidence regarding this important input to CEA.

Methods

We searched the MEDLINE, Scopus and EconLit databases for studies that estimated HRQoL in cervical cancer prevention and management published January 1995–December 2015. The primary inclusion criterion was for studies that assess HRQoL using the EQ-5D. Data were abstracted from eligible studies on setting, elicitation group, sample size, elicitation instruments, health state valuations, study design and follow-up. We assessed the quality and comparability of the studies with a particular focus on the HRQoL reported across states and groups.

Results

Fifteen papers met the inclusion criteria. Most used patient elicitation groups (n = 11), 2 used the general public and 2 used a mix of both. Eight studies were cross-sectional and seven were longitudinal. Six studies used both the EQ-5D-3L and the EQ-VAS together with other measures of overall HRQoL or condition-specific instruments. Extensive heterogeneity was observed across study characteristics.

Conclusions

Our results reveal the challenges of sourcing reliable estimates of HRQoL for use in CEAs of cervical cancer prevention and treatment. The EQ-5D appears insufficiently sensitive for some health states. A more general problem is the paucity of HRQoL estimates for many health states and their change over time.

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Notes

  1. Most VAS, including the EQ-VAS run from 0 to 100.

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Acknowledgements

This study was undertaken as part of the CERVIVA research consortium (www.cerviva.i.e.). AÓC (HRA-HSR/2012/30), JOM (ICE 2015-1037) and MOC (ICE 2015-1037) are supported by grants from the Health Research Board.

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Appendix

Appendix

See Table 4.

Table 4 Health state values for Galante et al. (2011)

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Ó Céilleachair, A., O’Mahony, J.F., O’Connor, M. et al. Health-related quality of life as measured by the EQ-5D in the prevention, screening and management of cervical disease: A systematic review. Qual Life Res 26, 2885–2897 (2017). https://doi.org/10.1007/s11136-017-1628-z

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