Health-Related Quality-of-Life and Cost Utility Analyses in Critical Care: A Systematic Review.

摘要: Objectives Cost utility analyses compare the costs and health outcome of interventions, with a denominator quality-adjusted life year, generic measure combining both quality quantity life. are difficult to when methods not standardized. It is unclear how cost measured/reported in critical care what methodologic challenges pose this setting. This may lead differences precluding comparisons. Therefore, we performed systematic review conducted care. Our objectives were understand: 1) characteristics, 2) health-related quality-of-life was measured/reported, 3) reported/measured. Design Systematic review. Data sources We systematically searched for MEDLINE, Embase, American College Physicians Journal Club, CENTRAL, Evidence-Based Medicine Reviews' selected subset archived versions UK National Health Service Economic Evaluation Database, Database Abstracts Reviews Effects, Association electronic databases from inception April 30, 2020. Setting Adult ICUs. Patients critically ill patients. Interventions None. Measurements main results Of 8,926 citations, 80 analyse studies eligible. The time horizon most commonly reported lifetime (59%). For reporting, infrequently measured (29% reported), only 5% reporting baseline quality-of-life. Indirect measures (generic, preference-based measurement tools) 85% (majority Euro-quality-of-life-5 Domains, 52%). Methods estimating seldom used patient incapacitated: imputation (19%), assigning fixed utilities incapacitation surrogates on behalf incapacitated patients (5%). transparency, separate incremental years 76% studies. Disaggregated (reporting years) described 34% Conclusions identified deficiencies which warrant recommendations (standardized measurement/reporting resource use/unit costs/health-related quality-of-life/methodological preferences) improved design, conduct, future