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EQ-5D studies in musculoskeletal and connective tissue diseases in eight Central and Eastern European countries: a systematic literature review and meta-analysis

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Abstract

EQ-5D is becoming the preferred instrument to measure health-state utilities involved in health technology assessment. The objective of this study is to assess the state of EQ-5D research in musculoskeletal disorders in 8 Central and Eastern European countries and to provide a meta-analysis of EQ-5D index scores. Original research articles published in any language between Jan 2000 and Sept 2016 were included, if they reported any EQ-5D outcome from at least two musculoskeletal patients from Austria, Bulgaria, the Czech Republic, Hungary, Poland, Romania, Slovakia, or Slovenia. Risk of bias was assessed with the Cochrane Collaboration’s tool. Twenty-nine articles (5992 patients) were included on rheumatoid arthritis (n = 7), osteoporosis (n = 5), chronic pain (n = 5), osteoarthritis (n = 4), ankylosing spondylitis (n = 2), psoriatic arthritis (n = 2), total hip replacement (n = 2), and scleroderma (n = 2). Low back pain was under-represented, while studies in neck pain, systemic lupus erythematosus, gout, and childhood disorders were lacking. EQ-5D index scores were reported in 24 studies, while the version of the instrument and the value-set was not specified in 41% and 46% of the articles, respectively. Meta-analysis was performed on 24 disease states involving 6876 observation points. Intervention effect was reported in 22 subgroups, out of which risk of bias was low in 41%. This review provides recommendations to improve reporting standards of EQ-5D results and highlights potential areas for future research. Coordinated research in conditions with greatest public health impact as well as a development of a regional value-set could provide locally relevant health-state utilities that are transferable among countries within the region.

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References

  1. Collaborators GDaH, (2015) Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet 386(10009):2145–2191

    Article  Google Scholar 

  2. Eurostat (2016) Population on 1 January. http://ec.europa.eu/eurostat/tgm/download.do?tab=table&plugin=1&language=en&pcode=tps00001

  3. WHO (2004) Deaths and DALY estimates for 2004 by cause for WHO Member States: Persons, all ages. http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/. Accessed 2016.09.08. 2006

  4. Brodszky V, Bálint P, Géher P et al (2009) Disease burden of psoriatic arthritis compared to rheumatoid arthritis. Hungarian experiment. Rheumatol Int 30(2):199–205

    Article  PubMed  Google Scholar 

  5. Petříková A, Doležal T, Klimeš J, Vocelka M, Sedová L, Kolář J (2013) The economic burden of the ankylosing spondylitis in the Czech Republic: comparison between 2005 and 2008. Rheumatol Int 33:1813–1819

    Article  PubMed  Google Scholar 

  6. Brodszky V, Baji P, Balogh O, Péntek M (2014) Budget impact analysis of biosimilar infliximab (CT-P13) for the treatment of rheumatoid arthritis in six Central and Eastern European countries. Eur J Health Econ 15(Suppl 1):S65–S71

    Article  PubMed  Google Scholar 

  7. Boncz I, Sebestyén A (2006) Financial deficits in the health services of the UK and Hungary. Lancet 368(9539):917–918

    Article  PubMed  Google Scholar 

  8. Joensuu JT, Huoponen S, Aaltonen KJ, Konttinen YT, Nordstrom D, Blom M (2015) The cost-effectiveness of biologics for the treatment of rheumatoid arthritis: a systematic review. PLoS ONE 10(3):e0119683

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cawson MR, Mitchell SA, Knight C et al (2014) Systematic review, network meta-analysis and economic evaluation of biological therapy for the management of active psoriatic arthritis. BMC Musculoskelet Disord 15:26

    Article  PubMed  PubMed Central  Google Scholar 

  10. Matcham F, Scott IC, Rayner L et al (2014) The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: a systematic review and meta-analysis. Semin Arthritis Rheum 44(2):123–130

    Article  PubMed  Google Scholar 

  11. Harrison MJ, Davies LM, Bansback NJ, Ingram M, Anis AH, Symmons DP (2008) The validity and responsiveness of generic utility measures in rheumatoid arthritis: a review. J Rheumatol 35(4):592–602

    PubMed  Google Scholar 

  12. EuroQol G (1990) EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16(3):199–208

    Article  Google Scholar 

  13. Brooks R (1996) EuroQol: the current state of play. Health Policy 37(1):53–72

    Article  CAS  PubMed  Google Scholar 

  14. Herdman M, Gudex C, Lloyd A et al (2011) Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 20(10):1727–1736

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. EuroQol G (2016) EQ-5D Homepage. http://www.euroqol.org/home.html

  16. Devlin NJ, Parkin D, Browne J (2010) Patient-reported outcome measures in the NHS: new methods for analysing and reporting EQ-5D data. Health Econ 19(8):886–905

    Article  PubMed  Google Scholar 

  17. Harrison MJ, Bansback NJ, Marra CA, Drummond M, Tugwell PS, Boonen A (2011) Valuing health for clinical and economic decisions: directions relevant for rheumatologists. J Rheumatol 38(8):1770–1775

    Article  PubMed  Google Scholar 

  18. Gulacsi L (2014) Health technology assessment in Poland, the Czech Republic, Hungary, Romania and Bulgaria. Eur J Health Econ 15:13–25

    Article  Google Scholar 

  19. Rencz F, Gulacsi L, Drummond M et al (2016) EQ-5D in Central and Eastern Europe: 2000–2015. Qual Life Res Int J Qual Life Aspects Treatment, Care Rehabil 25(11):2693–2710

    Article  Google Scholar 

  20. WHO (2016) International Statistical Classification of Diseases and Related Health Problems 10th Revision Version: 2016. http://apps.who.int/classifications/icd10/browse/2016/en. Accessed 14 Oct 2016

  21. Search Engine for EuroQol and EQ-5D-related material. http://www.euroqol.org/eq-5d-publications/search.html. Accessed 09 Jan 2016

  22. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535

    Article  PubMed  PubMed Central  Google Scholar 

  23. Higgins JPT, Green S, (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. (updated March 2011) The Cochrane Collaboration; 2011

  24. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188

    Article  CAS  PubMed  Google Scholar 

  25. Péntek M, Czirjak L, Pfliegler G, et al. (2015.) Lokalizált scleroderma és szisztémás sclerosis betegséggel élők életminősége és betegségterhe: a BURQOL-RD európai felmérés magyarországi eredményei (Quality of life and burden of disease in localised scleroderma and systemic sclerosis: Hungarian results of the European BURQOL-RD study). Immunológiai Szemle VII. (4):21–9

  26. Szűcs G, Gál J, Géher P, et al. (2015) A golimumab hatásossága és biztonságossága a betegség lefolyását módosító bázisterápiás szerek (DMARD-ok) mellett alkalmazva rheumatoid arthritisben: A GO-MORE vizsgálat magyarországi eredményei (Efficacy and safety of golimumab used in combination with disease modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis: Hungarian results of the GO-MORE study). Immunológiai Szemle VII. (3):59–66

  27. Khoshab HA, Sloboda T (2015) Minimal access spinal technologies (MAST) fusion procedures for the treatment of the degenerative lumbar spine (a part of multicentral prospective study). Case Report. Neuro Endocrinol Lett 36(3):231–235

    PubMed  Google Scholar 

  28. Kiraly E, Gondos T (2012) Cardiovascular diseases and the health-related quality of life after total hip replacement. J Clin Nurs 21(19–20):2843–2850

    Article  PubMed  Google Scholar 

  29. Klemenc-Ketiš Z (2011) Disability in patients with chronic non-specific low back pain: validation of the Slovene version of the Oswestry disability index. Slov J Publ Health 50(2):87–94

    Google Scholar 

  30. Pasek J, Kwiatek P, Pasek T, Szajkowski S, Szewc A, Sieron A (2012) Application of magnetic field and visible light in the treatment of low back pain and sciatic neuralgia. Aktualnosci Neurologiczne 12(1):65–68

    Google Scholar 

  31. Rosa J, Vanuga P, Noskovic M, Ritomsky A (2004) Profile of patients presenting with postmenopausal osteoporosis treated with raloxifene. Osteol Bull 9(1):18–21

    Google Scholar 

  32. Rupel VP, Ogorevc M (2014) Use of the EQ-5D instrument and value scale in comparing health states of patients in four health care programs among health care providers. Val Health Reg Issues 4:95–99

    Article  Google Scholar 

  33. Horak P, Skacelova M, Hejduk K, Smrzova A, Pavelka K (2013) Abatacept and its use in the treatment of rheumatoid arthritis (RA) in the Czech Republic-data from the ATTRA registry. Clin Rheumatol 32(10):1451–1458

    Article  PubMed  Google Scholar 

  34. Inotai A, Rojkovich B, Fulop A, Jaszay E, Agh T, Meszaros A (2012) Health-related quality of life and utility in patients receiving biological and non-biological treatments in rheumatoid arthritis. Rheumatol Int 32(4):963–969

    Article  PubMed  Google Scholar 

  35. Mészáros Á, Vincze Z (2003) Életminőség vizsgálata asthma bronchiálés és rheumatoid arthritises betegek körében. Orv Hetil 144(9):423–427

    PubMed  Google Scholar 

  36. Pentek M, Gulacsi L, Rojkovich B, Brodszky V, van Exel J, Brouwer WB (2014) Subjective health expectations at biological therapy initiation: a survey of rheumatoid arthritis patients and rheumatologists. Eur J Health Econ 15(Suppl 1):S83–S92

    Article  PubMed  Google Scholar 

  37. Pentek M, Szekanecz Z, Czirjak L et al (2008) Impact of disease progression on health status, quality of life and costs in rheumatoid arthritis in Hungary. Orv Hetil 149(16):733–741

    Article  PubMed  Google Scholar 

  38. Závada J, Uher M, Vencovsky J, Pavelka K (2014) Assessment of utility score EQ-D and estimating the Cost-utility of the first year of treatment by TNF inhibitors in a cohort of patients with Rheumatoid Arthritis during—results from the Czech biologics registry ATTRA. Ceska Revmatol 22(1):10–16

    Google Scholar 

  39. Borgstrom F, Lekander I, Ivergard M et al (2013) The international costs and utilities related to osteoporotic fractures study (ICUROS)—quality of life during the first 4 months after fracture. Osteoporos Int 24(3):811–823

    Article  CAS  PubMed  Google Scholar 

  40. Dimitrov N, Goycheva P, Petrov D (2015) Assessment of health related quality of life in male patients with major osteoporotic fractures by two generic healt status indices: a preliminary study. J Balkan Tribol Assoc 21(3):585–593

    Google Scholar 

  41. Péntek M, Licker-Fóris E, Lovas K et al (2003) Az életminőség mérése postmenopausalis osteoporosisban szenvedő betegeknél. Ca és Csont 6(4):158–163

    Google Scholar 

  42. Voko Z, Inotai A, Horváth C, Bors K, Speer G, Kaló Z (2013) Csontritkulásban szenvedő betegek életminősége ([Quality of life of patients with osteoporosis in Hungary]). Lege Artis Medicinae KID 3(4):40–41

    Google Scholar 

  43. Tefner IK, Kovacs C, Gaal R et al (2015) The effect of balneotherapy on chronic shoulder pain. A randomized, controlled, single-blind follow-up trial. A pilot study. Clin Rheumatol 34(6):1097–1108

    Article  PubMed  Google Scholar 

  44. Tefner IK, Nemeth A, Laszlofi A, Kis T, Gyetvai G, Bender T (2012) The effect of spa therapy in chronic low back pain: a randomized controlled, single-blind, follow-up study. Rheumatol Int 32(10):3163–3169

    Article  PubMed  Google Scholar 

  45. Kovacs C, Bozsik A, Pecze M, et al. (2016) Effects of sulfur bath on hip osteoarthritis: a randomized, controlled, single-blind, follow-up trial: a pilot study. International journal of biometeorology

  46. Kovacs C, Pecze M, Tihanyi A, Kovacs L, Balogh S, Bender T (2012) The effect of sulphurous water in patients with osteoarthritis of hand. Double-blind, randomized, controlled follow-up study. Clin Rheumatol 31(10):1437–1442

    Article  PubMed  Google Scholar 

  47. Kulisch A, Benko A, Bergmann A et al (2014) Evaluation of the effect of Lake Heviz thermal mineral water in patients with osteoarthritis of the knee: a randomized, controlled, single-blind, follow-up study. Eur J Phys Rehabil Med 50(4):373–381

    CAS  PubMed  Google Scholar 

  48. Tefner IK, Gaal R, Koroknai A et al (2013) The effect of Neydharting mud-pack therapy on knee osteoarthritis: a randomized, controlled, double-blind follow-up pilot study. Rheumatol Int 33(10):2569–2576

    Article  PubMed  Google Scholar 

  49. Kawalec P, Malinowski K (2015) Disease activity, quality of life and indirect costs of reduced productivity at work, generated by Polish patients with ankylosing spondylitis. Reumatologia 53(6):301–308

    Article  PubMed  Google Scholar 

  50. Mlcoch T, Sedova L, Stolfa J, et al. (2016) Mapping the relationship between clinical and quality-of-life outcomes in patients with ankylosing spondylitis. Expert Rev Pharmacoecon Outcomes Res 1–9

  51. Brodszky V, Pentek M, Balint PV et al (2010) Comparison of the Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire, the functional status (HAQ) and utility (EQ-5D) measures in psoriatic arthritis: results from a cross-sectional survey. Scand J Rheumatol 39(4):303–309

    Article  CAS  PubMed  Google Scholar 

  52. Rencz F, Brodszky V, Pentek M et al (2014) Disease burden of psoriasis associated with psoriatic arthritis in Hungary. Orv Hetil 155(48):1913–1921

    Article  PubMed  Google Scholar 

  53. Minier T, Pentek M, Brodszky V et al (2010) Cost-of-illness of patients with systemic sclerosis in a tertiary care centre. Rheumatology (Oxford) 49(10):1920–1928

    Article  Google Scholar 

  54. Jaromi M, Hanzel A, Endrei D et al (2014) Determination of the annual health insurance Cost Of outpatient care physiotherapy services For low back pain. Val Health J Int Soc Pharmacoecon Outcomes Res 17(7):A378

    Article  CAS  Google Scholar 

  55. Kuhlmann A, Schmidt T, Treskova M et al (2016) Social/economic costs and health-related quality of life in patients with juvenile idiopathic arthritis in Europe. Eur J Health Econ 17(Suppl 1):79–87

    Article  PubMed  Google Scholar 

  56. Knies S, Evers SM, Candel MJ, Severens JL, Ament AJ (2009) Utilities of the EQ-5D: transferable or not? Pharmacoeconomics 27(9):767–779

    Article  PubMed  Google Scholar 

  57. Szende A, Oppe M, Devlin N (2007) EQ-5D value sets: inventory, comparative review and user guide. Springer

  58. Golicki D, Jakubczyk M, Niewada M, Wrona W, Busschbach JJ (2010) Valuation of EQ-5D health states in Poland: first TTO-based social value set in Central and Eastern Europe. Val health J Int Soc Pharmacoecon Outcomes Res 13(2):289–297

    Article  Google Scholar 

  59. Dolan P (1997) Modeling valuations for EuroQol health states. Med Care 35(11):1095–1108

    Article  CAS  PubMed  Google Scholar 

  60. Gulácsi L (2014) Biological and biosimilar therapies in inflammatory conditions: challenges for the Central and Eastern European countries. Eur J Health Econ 15:1–4

    Article  Google Scholar 

  61. Boonen A, Patel V, Traina S, Chiou CF, Maetzel A, Tsuji W (2008) Rapid and sustained improvement in health-related quality of life and utility for 72 weeks in patients with ankylosing spondylitis receiving etanercept. J Rheumatol 35(4):662–667

    CAS  PubMed  Google Scholar 

  62. Choi C-B, Kim T-J, Park H-J et al (2008) Safety and clinical responses in Ankylosing Spondylitis after three months of etanercept therapy. J Korean Med Sci 23(5):852–856

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Møller AH, Erntoft S, Vinding GR, Jemec GBE (2015) A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values. Patient Related Outcome Meas 6:167–177

    Google Scholar 

  64. Rencz F, Hollo P, Karpati S et al (2015) Moderate to severe psoriasis patients’ subjective future expectations regarding health-related quality of life and longevity. J Eur Acad Dermatol Venereol 29(7):1398–1405

    Article  CAS  PubMed  Google Scholar 

  65. Russell AS, Conner-Spady B, Mintz A, Mallon C, Maksymowych WP (2003) The responsiveness of generic health status measures as assessed in patients with rheumatoid arthritis receiving infliximab. J Rheumatol 30(5):941–947

    CAS  PubMed  Google Scholar 

  66. Bingham CO 3rd, Weinblatt M, Han C et al (2014) The effect of intravenous golimumab on health-related quality of life in rheumatoid arthritis: 24-week results of the phase III GO-FURTHER trial. J Rheumatol 41(6):1067–1076

    Article  CAS  PubMed  Google Scholar 

  67. Kievit W, Fransen J, Adang EM et al (2011) Long-term effectiveness and safety of TNF-blocking agents in daily clinical practice: results from the Dutch Rheumatoid Arthritis Monitoring register. Rheumatology (Oxford) 50(1):196–203

    Article  CAS  Google Scholar 

  68. Gulfe A, Wallman JK, Kristensen LE (2016) EuroQol-5 dimensions utility gain according to British and Swedish preference sets in rheumatoid arthritis treated with abatacept, rituximab, tocilizumab, or tumour necrosis factor inhibitors: a prospective cohort study from southern Sweden. Arthritis Res Ther 18:51

    Article  PubMed  PubMed Central  Google Scholar 

  69. Buitinga L, Braakman-Jansen LM, Taal E et al (2012) Comparative responsiveness of the EuroQol-5D and Short Form 6D to improvement in patients with rheumatoid arthritis treated with tumor necrosis factor blockers: results of the Dutch Rheumatoid Arthritis Monitoring registry. Arthritis Care Res (Hoboken) 64(6):826–832

    Article  Google Scholar 

  70. Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A (1997) Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D). Br J Rheumatol 36(5):551–559

    Article  CAS  PubMed  Google Scholar 

  71. Pentek M, Rojkovich B, Czirjak L et al (2014) Acceptability of less than perfect health states in rheumatoid arthritis: the patients’ perspective. Eur J Health Econ 15(Suppl 1):S73–S82

    Article  PubMed  Google Scholar 

  72. Ruchlin HS, Insinga RP (2008) A review of health-utility data for osteoarthritis: implications for clinical trial-based evaluation. Pharmacoeconomics 26(11):925–935

    Article  PubMed  Google Scholar 

  73. Leboime A, Confavreux CB, Mehsen N, Paccou J, David C, Roux C (2010) Osteoporosis and mortality. Joint Bone Spine 77:S107–S112

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Doctoral School of Business and Management, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary

    Zsombor Zrubka

  2. Sandoz Hungária Kft, Bartók Béla u. 43-47, 1134, Budapest, Hungary

    Zsombor Zrubka

  3. Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary

    Zsombor Zrubka, Fanni Rencz, Valentin Brodszky, Petra Baji, László Gulácsi & Márta Péntek

  4. Institute of Rheumatology, Na Slupi 4, Prague, 128 00, Czech Republic

    Jakub Závada

  5. Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, ul. Banacha 1b, 02-097, Warsaw, Poland

    Dominik Golicki

  6. Institute for Economic Research, Kardeljeva ploščad 17, 1000, Ljubljana, Slovenia

    Valentina Prevolnik Rupel

  7. Department of Health Economics, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1 1090, Vienna, Austria

    Judit Simon

  8. Department of Social Pharmacy and Pharmacoeconomics, Faculty of Pharmacy, Medical University, Sofia, Bulgaria

    Guenka Petrova

  9. Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 22660, 1100 DD, Amsterdam, The Netherlands

    Alexandru Rotar

  10. Department of Rheumatology, Flór Ferenc County Hospital, Semmelweis tér 1, 2143, Kistarcsa, Hungary

    Márta Péntek

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  1. Zsombor Zrubka
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Conflict of interest

Fanni Rencz, Jakub Závada, Judit Simon, Valentin Brodszky, Petra Baji, Guenka Petrova László Gulácsi, and Márta Péntek have nothing to disclose. Zsombor Zrubka is a full-time employee of Sandoz Hungária Kft. The review is strictly the personal point of view of the author and it does not reflect the position of Sandoz. Dominik Golicki reports grants and non-financial support from EuroQol Group, outside the submitted work; and he is a member of the EuroQol Group, a not-for-profit organization that develops and distributes instruments that assess and value health. Valentina Prevolnik Rupel reports non-financial support from EuroQol Group, outside the submitted work; and she is member of the EuroQol Group, a not-for-profit organization that develops and distributes instruments that assess and value health. Alexandru Rotar is a salaried employee of Sanofi-Aventis Romania. The review is strictly the personal point of view of the author and it does not reflect the position of Sanofi-Aventis Romania.

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The study is a systematic review: for this type of study, formal consent is not required.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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The study is a systematic review: for this type of study, informed consent of participants is not required.

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This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Zrubka, Z., Rencz, F., Závada, J. et al. EQ-5D studies in musculoskeletal and connective tissue diseases in eight Central and Eastern European countries: a systematic literature review and meta-analysis. Rheumatol Int 37, 1957–1977 (2017). https://doi.org/10.1007/s00296-017-3800-8

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