Cost-effectiveness of interventions for medically unexplained symptoms: A systematic review.

摘要: Background In primary and secondary care medically unexplained symptoms (MUS) or functional somatic syndromes (FSS) constitute a major burden for patients society with high healthcare costs societal costs. Objectives were to provide an overview of the evidence regarding cost-effectiveness interventions MUS FSS, assess quality these studies. Methods We searched databases PubMed, PsycINFO, National Health Service Economic Evaluation Database (NHS-EED) CEA registry conduct systematic review. Articles full economic evaluations on focusing adult undifferentiated fibromyalgia (FM), irritable bowel syndrome (IBS) chronic fatigue (CFS), no restrictions comparators, published until 15 June 2018, included. excluded preventive interventions. Two reviewers independently extracted study characteristics data used Consensus Criteria Checklist appraise methodological quality. Results A total 39 studies out 1,613 articles met inclusion criteria. Twenty-two reported per quality-adjusted life year (QALY) gained cost-utility analyses (CUAs). 13 CUAs intervention conditions dominated control had incremental ratio below willingness-to-pay threshold € 50,000 QALY, meaning that (on average) cost-effective in comparison condition. Group (n = 3) FM 4) might be more than individual The included heterogeneous regard patients, interventions, design, outcomes. Conclusion This review provides FSS Considering limited comparability due heterogeneity studies, group Registration Study methods documented international prospective register reviews (PROSPERO) protocol, registration number: CRD42017060424.